Branch Therapy, PLLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP#4018 Issued in AR

Legal business name

BRANCH THERAPY, PLLC

Practice address

1202 NE McClain Rd
Bentonville, AR 72712-3875

Phone

(616) 255-5660

NPI assigned

Mar 14, 2016

Organization subpart

No

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

Authorized official

Name

Mitchell D Barker

Title

Organizer-Incorporator/ CCC-SLP

Phone

(616) 255-6609

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462924800000",
    "number": "1922469246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 NE MCCLAIN RD",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123875",
            "telephone_number": "616-255-6609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 NE MCCLAIN RD",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123875",
            "telephone_number": "616-255-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANCH THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-14",
        "last_updated": "2016-05-11",
        "status": "A",
        "authorized_official_last_name": "BARKER",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ORGANIZER-INCORPORATOR/ CCC-SLP",
        "authorized_official_telephone_number": "616-255-6609"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP#4018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2016; 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.