Individual provider Active NPI

Jessica Risner

  • Speech-Language Pathologist
  • Pine Bluff, AR
National Provider Identifier
1588085682
Registry record updated Dec 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
2003 University Dr Ste 2
Pine Bluff, AR 71601-2463
Phone
(870) 671-4871
Fax
(870) 671-4872
NPI assigned
Dec 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2013

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 AR Primary

Addresses

Primary practice location

2003 University Dr Ste 2
Pine Bluff, AR 71601-2463

Mailing address

3403 Quail Ridge Rd
Jonesboro, AR 72404-7781
Phone (870) 371-2108

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fox-Trot Therapy Services Past Accepting new patients
Fox-Trot Therapy Services, Inc Speech-Language Pathologist PastSince Dec 13, 2013 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": "1387238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387238400000",
    "number": "1588085682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3403 QUAIL RIDGE RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724047781",
            "telephone_number": "870-371-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 UNIVERSITY DR STE 2",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716012463",
            "telephone_number": "870-671-4871",
            "fax_number": "870-671-4872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISNER",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-17",
        "last_updated": "2013-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2013; 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.