Individual provider Active NPI

Fran Hagstrom, PH.D.

  • Speech-Language Pathologist
  • Fayetteville, AR
National Provider Identifier
1972626570
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP#1987 Issued in AR
Practice address
410 Arkansas Ave
Speech & Hearing Clinic
Fayetteville, AR 72701-1201
Phone
(479) 575-4910
Fax
(479) 575-4507
NPI assigned
Apr 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP#1987 AR Primary

Addresses

Primary practice location

410 Arkansas Ave
Speech & Hearing Clinic
Fayetteville, AR 72701-1201

Mailing address

410 Arkansas Ave
Speech & Hearing Clinic
Fayetteville, AR 72701-1201
Phone (479) 575-4910

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
SP#1987ARMDSpeech-Language Pathologist

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": "1972626570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 ARKANSAS AVE",
            "address_2": "SPEECH & HEARING CLINIC",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727011201",
            "telephone_number": "479-575-4910",
            "fax_number": "479-575-4507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 ARKANSAS AVE",
            "address_2": "SPEECH & HEARING CLINIC",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727011201",
            "telephone_number": "479-575-4910",
            "fax_number": "479-575-4507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGSTROM",
        "first_name": "FRAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "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": "SP#1987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, 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.

Verify at the official NPI Registry.