Melanie Renee Kauffman, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Fordyce, AR
NPI 1720137987 · NPPES record last updated Jul 22, 2011
Key facts
- NPI
- 1720137987
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 858 (AR)
- Practice address
- 1717 Industrial Dr
Fordyce, AR 71742-7104 - Phone
- (870) 352-7975
- NPI assigned
- Jan 9, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 858 | AR | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Step, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 858 | AR | Yes |
Addresses
Primary practice location
1717 Industrial Dr
Fordyce, AR 71742-7104
Mailing address
1722 Abernathy St
Fordyce, AR 71742-2906
Phone (870) 352-5033
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SP #858 | Other | AR | STATE LICENSURE |
| 132032721 | Medicaid | AR | |
| 01090743 | Other | AR | ASHA ACCOUNT NUMBER |
Other providers in Fordyce, AR
- Eric Johnson
- Rebekah Johnson
- Susan Kay Johnson
- Kauffman Dental Clinic, PLLC
- Charles E. Kauffman Jr.
- Deirdra Sandoral Kervin
- Shanna Lamb
- Lekita Lee
- Lindsey Walley MD PLLC PA
- Brittany Livingston
All providers in Fordyce, AR · Speech-Language Pathologist in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.