Alyssa D. Ivy, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP#2254 Issued in AR

Practice address

307 Coachlight Dr
Bentonville, AR 72712-5453

Phone

(479) 790-2137

NPI assigned

Jul 5, 2006

Last updated

Feb 25, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203897600000",
    "number": "1841220555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 COACHLIGHT DR",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727125453",
            "telephone_number": "479-790-2137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 COACHLIGHT DR",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727125453",
            "telephone_number": "479-790-2137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVY",
        "first_name": "ALYSSA",
        "middle_name": "D.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2008-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP#2254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "5Y634",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Irons, DDS
• Scott Sullivan Ironside, PT
• Andrea Shanell Ittner, ATC
• Ivey Family Medicine
• Traci L Ivey, MD
• Joseph J Ivy, M.D.
• J & G Ventures, Inc (BrightStar of Benton County)
• J. Anthony Smith DDS PA
• Katherine Jaber
• Alexis R Jackson

• Speech-Language Pathologist in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Speech-Language Pathologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.

Verify at the official NPI Registry.