NPIMap

Organization Active NPI

Fusion Therapy Center, LLC

  • Speech-Language Pathologist
  • Bentonville, AR
National Provider Identifier
1801552435
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
FUSION THERAPY CENTER, LLC
Practice address
1803 SW Regional Airport Blvd Ste 9
Bentonville, AR 72713-8792
Phone
(479) 616-2727
NPI assigned
Nov 9, 2021
Last updated
Nov 9, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Authorized official

Name
Jeanne HaleNPI 1932423167
Title
Co-Owner, SLP
Phone
(479) 616-2727

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Occupational Therapist 225X00000X
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

1803 SW Regional Airport Blvd Ste 9
Bentonville, AR 72713-8792

Mailing address

4606 SW Skyline St
Bentonville, AR 72713-7806
Phone (479) 616-2727

Other identifiers 1

IdentifierTypeStateIssuer
182161721MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230613003817 AR Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3173981776 Receives reassigned benefits from 49 practitioners
Practice locations: Bentonville, AR

National Provider Directory

National Provider Directory

Locations

3108 SW Regency Pkwy
Ste 5
Bentonville, AR 72712
Phone (479) 252-3321

3201 SW Regency Pkwy
Ste 5
Bentonville, AR 72712
Phone (479) 252-3321

Practitioners & affiliated clinicians

Practitioners 64

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 64

NPI Registry JSON

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636416000000",
    "number": "1801552435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4606 SW SKYLINE ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727137806",
            "telephone_number": "479-616-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 SW REGIONAL AIRPORT BLVD STE 9",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727138792",
            "telephone_number": "479-616-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUSION THERAPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-09",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A",
        "authorized_official_last_name": "HALE",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_title_or_position": "CO-OWNER, SLP",
        "authorized_official_telephone_number": "479-616-2727"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182161721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.