Active NPI
Kayla Short, CCC-SLP
- Speech-Language Pathologist
- Fort Smith, AR
National Provider Identifier
1972199248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 202171
- Practice address
- 314 S 17TH St
Fort Smith, AR 72901-3836 - Phone
- (479) 782-1444
- NPI assigned
- Dec 21, 2020
- 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 | 202171 | AR | Primary |
Addresses
Primary practice location
314 S 17TH St
Fort Smith, AR 72901-3836
Mailing address
476647 E 1095 Rd
Roland, OK 74954-3836
Phone (479) 353-5158
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 |
|---|---|---|---|
| 202171 | AR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721692800000",
"number": "1972199248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "476647 E 1095 RD",
"city": "ROLAND",
"state": "OK",
"postal_code": "749543836",
"telephone_number": "479-353-5158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "314 S 17TH ST",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729013836",
"telephone_number": "479-782-1444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHORT",
"first_name": "KAYLA",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-21",
"last_updated": "2024-07-23",
"certification_date": "2024-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AR",
"license": "202171",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Smith, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.