Individual provider Active NPI

Carla Sue Sumner

  • Speech-Language Pathologist
  • West Memphis, AR
National Provider Identifier
1821292715
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP1055 Issued in AR
Practice address
610 S Avalon St
West Memphis, AR 72301-4109
Phone
(870) 400-3481
NPI assigned
Jun 13, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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 SP1055 AR Primary

Addresses

Primary practice location

610 S Avalon St
West Memphis, AR 72301-4109

Mailing address

110 Mole Mountain CT # 20441
Jasper, GA 30143-7583
Phone (770) 893-2470

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200803001366 AR Practitioner - Qualified Speech Language Pathologist 7315017555 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Reaper Physical Therapy Inc CurrentSince Jun 19, 2020 Accepting new patients

Locations

2918 Hawkins Dr
Searcy, AR 72143
Phone (501) 279-9255

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.

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821292715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MOLE MOUNTAIN CT # 20441",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301437583",
            "telephone_number": "770-893-2470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 S AVALON ST",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723014109",
            "telephone_number": "870-400-3481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMNER",
        "first_name": "CARLA",
        "middle_name": "SUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP1055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Memphis, 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.
  • 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.