Active NPI
Elizabeth K. Boschetti, MA,CFY-SLP
- Speech-Language Pathologist
- Benton, AR
National Provider Identifier
1902135403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP#P8288
- Practice address
- 17706 Interstate 30
Suite 3
Benton, AR 72019-2907 - Phone
- (501) 315-4414
- Fax
- (501) 315-3467
- NPI assigned
- Dec 11, 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 | SP#P8288 | AR | Primary |
Addresses
Primary practice location
17706 Interstate 30
Suite 3
Benton, AR 72019-2907
Mailing address
2610 Creekside Dr
Little Rock, AR 72211-4579
Phone (501) 231-0255
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180463721 | Medicaid | AR | |
| SP#P8288 | Other | AR | ARKANSAS BOARD OF EXAMINERS SPEECH LANGUAGE PATHOLOGY AND AUDIOLOGY |
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 |
|---|---|---|---|
| SP#P8288 | AR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288915200000",
"number": "1902135403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2610 CREEKSIDE DR",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722114579",
"telephone_number": "501-231-0255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17706 INTERSTATE 30",
"address_2": "SUITE 3",
"city": "BENTON",
"state": "AR",
"postal_code": "720192907",
"telephone_number": "501-315-4414",
"fax_number": "501-315-3467"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSCHETTI",
"first_name": "ELIZABETH",
"middle_name": "K.",
"name_prefix": "Mrs.",
"credential": "MA,CFY-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-12-11",
"last_updated": "2010-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AR",
"license": "SP#P8288",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "180463721",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARKANSAS BOARD OF EXAMINERS SPEECH LANGUAGE PATHOLOGY AND AUDIOLOGY",
"identifier": "SP#P8288",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Benton, AR
- Mary Bonner, PHD
- Bonnie Bryant LPC Therapy Services LLC
- Debaney Booker, RECOVERY ASSISTANT
- Natasha Booth, RECOVERY ASSISTANT
- David Borneman, RECOVERY ASSISTANT
- Nicholas Bostad, RECOVERY ASSISTANT
- Stephanie A Bostad, RECOVERY ADVOCATE
- Andrea Renee Boston, PLMSW
- Michael Bourns, D.D.S.
- Molly Bowers, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.