Individual provider Active NPI

Janna Leigh Hines, MS, CCC-SLP

  • Speech-Language Pathologist
  • Bentonville, AR
National Provider Identifier
1508823063
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1837 Issued in AR
Practice address
3104 NE 12TH St
Bentonville, AR 72712-3717
Phone
(479) 696-8819
Fax
(501) 542-4171
NPI assigned
Apr 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X
Speech-Language Pathologist 235Z00000X 1837 AR Primary

Addresses

Primary practice location

3104 NE 12TH St
Bentonville, AR 72712-3717

Mailing address

3104 NE 12TH St
Bentonville, AR 72712-3717
Phone (479) 544-2734

Other identifiers 1

IdentifierTypeStateIssuer
152411721MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1837ARMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Janna L Hines Therapy Services LLC Speech-Language Pathologist CurrentSince Mar 12, 2023 Accepting new patients
Absolute Pediatric Therapy Speech-Language Pathologist PastSince Dec 5, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1508823063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 NE 12TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123717",
            "telephone_number": "479-544-2734",
            "fax_number": "855-975-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 NE 12TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123717",
            "telephone_number": "479-696-8819",
            "fax_number": "501-542-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINES",
        "first_name": "JANNA",
        "middle_name": "LEIGH",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "1837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152411721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.