Active NPI
Kellie L Paxton, S.L.P.
- Speech-Language Pathologist
- Rogers, AR
National Provider Identifier
1811166226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 12061606
- Practice address
- 5305 Village Pkwy Ste 1
Rogers, AR 72758-8116 - Phone
- (479) 387-4796
- NPI assigned
- Feb 29, 2008
- 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 | 12061606 | AR | Primary |
Addresses
Primary practice location
5305 Village Pkwy Ste 1
Rogers, AR 72758-8116
Mailing address
5305 Village Pkwy Ste 1
Rogers, AR 72758-8116
Phone (479) 387-4796
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 |
|---|---|---|---|
| 12061606 | AR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204243200000",
"number": "1811166226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5305 VILLAGE PKWY STE 1",
"city": "ROGERS",
"state": "AR",
"postal_code": "727588116",
"telephone_number": "479-387-4796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5305 VILLAGE PKWY STE 1",
"city": "ROGERS",
"state": "AR",
"postal_code": "727588116",
"telephone_number": "479-387-4796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAXTON",
"first_name": "KELLIE",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "S.L.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-29",
"last_updated": "2008-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AR",
"license": "12061606",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rogers, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.