Early Learning Pediatric Therapy, Inc

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

EARLY LEARNING PEDIATRIC THERAPY, INC

Practice address

1701 S Highway 161
Jacksonville, AR 72076-5508

Phone

(501) 985-2323

NPI assigned

Jul 14, 2011

Organization subpart

No

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

Authorized official

Name

Robert Tallon

Title

President

Phone

(501) 985-2323

Specialties & licenses 3

Addresses

Other identifiers 1

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310601600000",
    "number": "1902194756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 GRANDVIEW ST",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721203224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 S HIGHWAY 161",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720765508",
            "telephone_number": "501-985-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARLY LEARNING PEDIATRIC THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-14",
        "last_updated": "2011-07-14",
        "status": "A",
        "authorized_official_last_name": "TALLON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-985-2323"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187287742",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Jacksonville, AR
• Providers in Jacksonville, 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 Jul 14, 2011; 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.