Individual provider Active NPI

Chenell Chenise Loudermill, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Little Rock, AR
National Provider Identifier
1619096492
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2185 Issued in AR
Practice address
52 Woodridge Dr.
Little Rock, AR 72204
Phone
(501) 407-9488
Fax
(501) 407-0515
NPI assigned
Mar 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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 2185 AR Primary

Addresses

Primary practice location

52 Woodridge Dr.
Little Rock, AR 72204

Mailing address

715 Clinic Dr
West Lafayette, IN 47907-2122
Phone (501) 407-9488

Other identifiers 1

IdentifierTypeStateIssuer
156337721MedicaidAR

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2185ARMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Uneek Kids, Inc Speech-Language Pathologist Past Accepting new patients
Purdue University Past 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": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1619096492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 CLINIC DR",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "479072122",
            "telephone_number": "501-407-9488",
            "fax_number": "501-407-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 WOODRIDGE DR.",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72204",
            "telephone_number": "501-407-9488",
            "fax_number": "501-407-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUDERMILL",
        "first_name": "CHENELL",
        "middle_name": "CHENISE",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "2185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156337721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; 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.