NPIMap

Organization Active NPI

Therateam Rehab Services

  • Speech-Language Pathologist
  • Roland, AR
National Provider Identifier
1639136807
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP #1076 Issued in AR
Legal business name
THERATEAM REHAB SERVICES
Practice address
20900 Roland Heights Rd
Roland, AR 72135-9685
Phone
(501) 868-4760
Fax
(501) 868-6498
NPI assigned
Apr 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Authorized official

Name
Mrs. Reeda Ruth Williamson, M.S.E., CCC-SLPNPI 1134187628
Title
President/Speech Language Pathologi
Phone
(501) 868-4760

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X SP #1076 AR Primary

Addresses

Primary practice location

20900 Roland Heights Rd
Roland, AR 72135-9685

Mailing address

20900 Roland Heights Rd
Roland, AR 72135-9685
Phone (501) 868-4760

Other identifiers 2

IdentifierTypeStateIssuer
148906742MedicaidAR
5F297OtherARBCBS GROUP PROVIDER #

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1146268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1639136807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20900 ROLAND HEIGHTS RD",
            "city": "ROLAND",
            "state": "AR",
            "postal_code": "721359685",
            "telephone_number": "501-868-4760",
            "fax_number": "501-868-6498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20900 ROLAND HEIGHTS RD",
            "city": "ROLAND",
            "state": "AR",
            "postal_code": "721359685",
            "telephone_number": "501-868-4760",
            "fax_number": "501-868-6498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERATEAM REHAB SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-29",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "WILLIAMSON",
        "authorized_official_first_name": "REEDA",
        "authorized_official_middle_name": "RUTH",
        "authorized_official_title_or_position": "PRESIDENT/SPEECH LANGUAGE PATHOLOGI",
        "authorized_official_telephone_number": "501-868-4760",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S.E., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP #1076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148906742",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP PROVIDER #",
            "identifier": "5F297",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roland, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.