Active NPI
Katie Ellen Stilwell Bloodworth, MA, CCC-SLP
- Speech-Language Pathologist
- Rogers, AR
National Provider Identifier
1831424720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP3231
- Practice address
- 4408 Walnut Street
Suite 7
Rogers, AR 72756-5006 - Phone
- (479) 246-0101
- Fax
- (901) 531-6735
- NPI assigned
- Oct 9, 2009
- Sex
- Female
- Sole proprietor
- No
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 | SP3231 | AR | Primary |
Addresses
Primary practice location
4408 Walnut Street
Suite 7
Rogers, AR 72756-5006
Mailing address
103 Ridgefield Street
Bentonville, AR 72712
Phone (501) 590-6272
Other names 1
- Miss Katie Ellen Stilwell
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP3231 | AR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426464000000",
"number": "1831424720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 RIDGEFIELD STREET",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "72712",
"telephone_number": "501-590-6272",
"fax_number": "901-531-6735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4408 WALNUT STREET",
"address_2": "SUITE 7",
"city": "ROGERS",
"state": "AR",
"postal_code": "727565006",
"telephone_number": "479-246-0101",
"fax_number": "901-531-6735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STILWELL BLOODWORTH",
"first_name": "KATIE",
"middle_name": "ELLEN",
"name_prefix": "Mrs.",
"credential": "MA, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-09",
"last_updated": "2015-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AR",
"license": "SP3231",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KATIE",
"last_name": "STILWELL",
"middle_name": "ELLEN",
"prefix": "MISS",
"credential": "MA, CCC-SLP",
"code": "1",
"type": "Former Name"
}
]
}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 Mar 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.