Active NPI
Simone Frayser Wood, MCD,CCC-SLP
- Speech-Language Pathologist
- Pine Bluff, AR
National Provider Identifier
1871616300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1260
- Practice address
- 912 W 6TH Ave
Pine Bluff, AR 71601-4033 - Phone
- (870) 534-0135
- NPI assigned
- Apr 9, 2007
- Last updated
- Jul 8, 2007
- 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 | 1260 | AR | Primary |
Addresses
Primary practice location
912 W 6TH Ave
Pine Bluff, AR 71601-4033
Mailing address
7501 Gibbins Rd
Pine Bluff, AR 71603-9380
Phone (870) 879-3834
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 |
|---|---|---|---|
| 1260 | AR | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ar River Education Service Cooperative | Past | Accepting new patients |
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.
-
- Local Education Agency (LEA)
- Pine Bluff, AR
- NPI 1750402772
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871616300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7501 GIBBINS RD",
"city": "PINE BLUFF",
"state": "AR",
"postal_code": "716039380",
"telephone_number": "870-879-3834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "912 W 6TH AVE",
"city": "PINE BLUFF",
"state": "AR",
"postal_code": "716014033",
"telephone_number": "870-534-0135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "SIMONE",
"middle_name": "FRAYSER",
"name_prefix": "Mrs.",
"credential": "MCD,CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AR",
"license": "1260",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pine Bluff, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.