Individual provider Active NPI

Edythe Yung, SPEECH THERAPIST

  • Speech-Language Pathologist
  • North Little Rock, AR
National Provider Identifier
1780749580
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP1674 Issued in AR
Practice address
4901 N Shore Dr
North Little Rock, AR 72118-5293
Phone
(501) 791-3331
Fax
(501) 791-0294
NPI assigned
Dec 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP1674 AR Primary

Addresses

Primary practice location

4901 N Shore Dr
North Little Rock, AR 72118-5293

Mailing address

4901 N Shore Dr
North Little Rock, AR 72118-5293
Phone (501) 791-3331

Other identifiers 1

IdentifierTypeStateIssuer
5U826OtherARBLUE CROSS BLUE SHIELD

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

LicenseStateTypeSpecialty
SP1674ARMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Busy Bees Pediatric Therapy Services, Inc. Speech-Language Pathologist 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780749580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 N SHORE DR",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721185293",
            "telephone_number": "501-791-3331",
            "fax_number": "501-791-0294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 N SHORE DR",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721185293",
            "telephone_number": "501-791-3331",
            "fax_number": "501-791-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUNG",
        "first_name": "EDYTHE",
        "credential": "SPEECH THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP1674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5U826",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.