Active NPI
Laura Beth Bassham, M.C.D.
- Speech-Language Pathologist
- Wynne, AR
National Provider Identifier
1770730723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1024
- Practice address
- 1300 Falls Blvd N
Wynne, AR 72396-1622 - Phone
- (870) 238-5032
- NPI assigned
- Aug 21, 2008
- Last updated
- Jan 6, 2009
- Sex
- Female
- Sole proprietor
- No
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 | 1024 | AR | Primary |
Addresses
Primary practice location
1300 Falls Blvd N
Wynne, AR 72396-1622
Mailing address
3419 Highway 284
Wynne, AR 72396-8116
Phone (870) 588-1239
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 173592795 | Medicaid | AR |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1024 | AR | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wynne Public Schools | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Local Education Agency (LEA)
- Wynne, AR
- NPI 1457486995
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231200000000",
"number": "1770730723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3419 HIGHWAY 284",
"city": "WYNNE",
"state": "AR",
"postal_code": "723968116",
"telephone_number": "870-588-1239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 FALLS BLVD N",
"city": "WYNNE",
"state": "AR",
"postal_code": "723961622",
"telephone_number": "870-238-5032"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASSHAM",
"first_name": "LAURA",
"middle_name": "BETH",
"name_prefix": "Mrs.",
"credential": "M.C.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-21",
"last_updated": "2009-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AR",
"license": "1024",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "173592795",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wynne, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.