Active NPI
Mylena Jo Noble, SLP
- Speech-Language Pathologist
- Prairie Grove, AR
National Provider Identifier
1801137237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP#2946
- Practice address
- 11071 Rosebay LN
Prairie Grove, AR 72753-8322 - Phone
- (870) 500-3788
- NPI assigned
- Mar 11, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 | SP#2946 | AR | Primary |
Addresses
Primary practice location
11071 Rosebay LN
Prairie Grove, AR 72753-8322
Mailing address
11071 Rosebay LN
Prairie Grove, AR 72753-8322
Phone (870) 500-3788
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 |
|---|---|---|---|
| SP#2946 | AR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362960000000",
"number": "1801137237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11071 ROSEBAY LN",
"city": "PRAIRIE GROVE",
"state": "AR",
"postal_code": "727538322",
"telephone_number": "870-500-3788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11071 ROSEBAY LN",
"city": "PRAIRIE GROVE",
"state": "AR",
"postal_code": "727538322",
"telephone_number": "870-500-3788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOBLE",
"first_name": "MYLENA",
"middle_name": "JO",
"name_prefix": "Mrs.",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-11",
"last_updated": "2013-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AR",
"license": "SP#2946",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prairie Grove, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.