Active NPI
Regina S Kelley, MA CCC-SLP
- Speech-Language Pathologist
- Benton, AR
National Provider Identifier
1992834675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP#1751
- Practice address
- 121 Cox St
Benton, AR 72015-4611 - Phone
- (501) 776-0691
- Fax
- (501) 776-0692
- NPI assigned
- Mar 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
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#1751 | AR | Primary |
Addresses
Primary practice location
121 Cox St
Benton, AR 72015-4611
Mailing address
1203 Kynlee CV
Bryant, AR 72022-8509
Phone (501) 847-0553
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#1751 | AR | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Civitan Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Developmentally Disabled Services Day Training Agency
- Benton, AR
- NPI 1508917295
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1992834675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1203 KYNLEE CV",
"city": "BRYANT",
"state": "AR",
"postal_code": "720228509",
"telephone_number": "501-847-0553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 COX ST",
"city": "BENTON",
"state": "AR",
"postal_code": "720154611",
"telephone_number": "501-776-0691",
"fax_number": "501-776-0692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEY",
"first_name": "REGINA",
"middle_name": "S",
"name_prefix": "Mrs.",
"credential": "MA CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-05",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AR",
"license": "SP#1751",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Benton, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.