Jamie Pulliza, SP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP#2647 Issued in AR

Practice address

1125 N College Ave
Fayetteville, AR 72703-1908

Phone

(479) 713-8630

Fax

(479) 713-8639

NPI assigned

Nov 25, 2014

Last updated

Nov 25, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1416873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416873600000",
    "number": "1619374303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 N COLLEGE AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031908",
            "telephone_number": "479-713-8630",
            "fax_number": "479-713-8639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 N COLLEGE AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031908",
            "telephone_number": "479-713-8630",
            "fax_number": "479-713-8639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLIZA",
        "first_name": "JAMIE",
        "credential": "SP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-25",
        "last_updated": "2014-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP#2647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Speech-Language Pathologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; 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.