Active NPI
Mandi Leann Burcham, M.S., CCC-SLP
- Speech-Language Pathologist
- Rogers, AR
National Provider Identifier
1619991940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP#2238
- Practice address
- 2801 Wellington Cir Apt E3
Rogers, AR 72758-3908 - Phone
- (479) 790-0120
- NPI assigned
- Jul 27, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP#2238 | AR | Primary |
Addresses
Primary practice location
2801 Wellington Cir Apt E3
Rogers, AR 72758-3908
Mailing address
2801 Wellington Cir Apt E3
Rogers, AR 72758-3908
Phone (479) 790-0120
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5Y071 | Other | AR | BC/BS |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP#2238 | AR | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellness Professionals, Inc. | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Chiropractor
- Fayetteville, AR
- NPI 1992973119
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206489600000",
"number": "1619991940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 WELLINGTON CIR APT E3",
"city": "ROGERS",
"state": "AR",
"postal_code": "727583908",
"telephone_number": "479-790-0120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 WELLINGTON CIR APT E3",
"city": "ROGERS",
"state": "AR",
"postal_code": "727583908",
"telephone_number": "479-790-0120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURCHAM",
"first_name": "MANDI",
"middle_name": "LEANN",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-27",
"last_updated": "2008-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AR",
"license": "SP#2238",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "5Y071",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rogers, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.