Individual provider Active NPI

Deanna L Prince, M.C.D., CCC-SLP

  • Speech-Language Pathologist
  • Newport, AR
National Provider Identifier
1528100666
Registry record updated Jan 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP #794 Issued in AR
Practice address
221 Lindley LN
Uams-Kids First Newport
Newport, AR 72112-4954
Phone
(870) 523-2124
NPI assigned
Feb 13, 2007
Last updated
Jan 11, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP #794 AR Primary

Addresses

Primary practice location

221 Lindley LN
Uams-Kids First Newport
Newport, AR 72112-4954

Mailing address

604 Live Oak Dr
Searcy, AR 72143-4530
Phone (501) 230-9995

Other identifiers 1

IdentifierTypeStateIssuer
123431721MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181212002212 AR Practitioner - Qualified Speech Language Pathologist 4688919079 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP #794ARMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Gross Therapy Services, Inc. Speech-Language Pathologist CurrentSince Oct 7, 2019 Accepting new patients
Reaper Physical Therapy Inc CurrentSince Oct 17, 2018 Accepting new patients
Newport Advanced Physical Therapy, Inc. CurrentSince Oct 1, 2019 Accepting new patients
Leap Therapy Solutions, LLC Speech-Language Pathologist Past Accepting new patients

Locations

801 Malcolm Ave
Newport, AR 72112
Phone (870) 523-6500

2918 Hawkins Dr
Searcy, AR 72143
Phone (501) 279-9255

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452470400000",
    "number": "1528100666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 LIVE OAK DR",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721434530",
            "telephone_number": "501-230-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 LINDLEY LN",
            "address_2": "UAMS-KIDS FIRST NEWPORT",
            "city": "NEWPORT",
            "state": "AR",
            "postal_code": "721124954",
            "telephone_number": "870-523-2124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "DEANNA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "M.C.D., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2016-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP #794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123431721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.