Individual provider Active NPI

Dana L Sitkowski

  • Speech-Language Pathologist
  • Mountain Home, AR
National Provider Identifier
1609021716
Registry record updated Nov 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP#939 Issued in AR
Practice address
62 Magnolia CT
Mountain Home, AR 72653-8776
Phone
(870) 492-2008
NPI assigned
Nov 18, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2008

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 SP#939 AR Primary
Speech-Language Pathologist 235Z00000X 01111505 MD

Addresses

Primary practice location

62 Magnolia CT
Mountain Home, AR 72653-8776

Mailing address

62 Magnolia CT
Mountain Home, AR 72653-8776
Phone (870) 492-2008

Other identifiers 1

IdentifierTypeStateIssuer
127662721MedicaidAR

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

State licenses

LicenseStateTypeSpecialty
SP#939ARMDSpeech-Language Pathologist
01111505MDMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1226966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226966400000",
    "number": "1609021716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 MAGNOLIA CT",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726538776",
            "telephone_number": "870-492-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 MAGNOLIA CT",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726538776",
            "telephone_number": "870-492-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SITKOWSKI",
        "first_name": "DANA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-18",
        "last_updated": "2008-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP#939",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "01111505",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127662721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2008; 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.