Susan B. Jeter

Primary specialty

Speech/Language/Hearing Specialist/TechnologistTaxonomy code 235500000X

License

97-05E Issued in AR

Practice address

10618 Breckenridge Dr
Little Rock, AR 72211-1802

Phone

(501) 217-8600

NPI assigned

Sep 10, 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 identifiers 1

Other names 1

• Mrs. Susan B. Jeter Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189382400000",
    "number": "1760677074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 LIVE OAKS DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722239340",
            "telephone_number": "501-246-5308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10618 BRECKENRIDGE DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722111802",
            "telephone_number": "501-217-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETER",
        "first_name": "SUSAN",
        "middle_name": "B.",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-10",
        "last_updated": "2007-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235500000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist",
            "state": "AR",
            "license": "97-05E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ARKANSAS",
            "identifier": "97-05E",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "JETER",
            "middle_name": "B.",
            "prefix": "MRS.",
            "credential": "MS,LPE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Joshua Jervis-Bardy, MD PHD
• Dane Jester
• John Jestus
• Alexandra Jeter
• Marci Jeter, MS-CCC, SLP
• Vicki Lynn Jett, P.T.
• Stephanie Rachelle Jez, MS
• Bei Jia, MD, MS
• Chasity Jiles, LCSW, LADAC, ICADC
• Tenisha Jiles

• Speech/Language/Hearing Specialist/Technologist in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Speech/Language/Hearing Specialist/Technologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2007; 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.