Krystal Lori Jordan, MCD, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

P8032 Issued in AR

Practice address

3423 E Highland Dr
Ste. a
Jonesboro, AR 72401-6404

Phone

(870) 336-0021

NPI assigned

Aug 31, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Krystal Lori Schubach Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Jonesboro Pediatric Therapy, Inc.

  • Speech-Language Pathologist
  • Bono, AR
  • NPI 1609490671
  NPD Authorized official

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

{
    "created_epoch": "1188518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242691200000",
    "number": "1689868655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 STONEY DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724049571",
            "telephone_number": "870-219-5534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3423 E HIGHLAND DR",
            "address_2": "STE. A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724016404",
            "telephone_number": "870-336-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "KRYSTAL",
        "middle_name": "LORI",
        "name_prefix": "Mrs.",
        "credential": "MCD, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-31",
        "last_updated": "2009-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "P8032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRYSTAL",
            "last_name": "SCHUBACH",
            "middle_name": "LORI",
            "prefix": "MISS",
            "credential": "MCD, CF-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jonesboro Surgery Center Anesthesia
• Jonesboro Surgery Center, LLC
• Jonesboro Surgical Associates
• Jonesboro Wellness LLC
• Holly Anne Jordan, MHPP
• Wendy Jordan, PHARM.D.
• Sonia R Joseph, DO
• Journey Health and Wellness, PLC
• Donna Annett Joyce, MS CCC-SLP
• JP&O LLC

• All providers in Jonesboro, AR
• Speech-Language Pathologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2009; 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.