Individual provider Active NPI

Jana Marie Smith, CCC/SLP

  • Speech-Language Pathologist
  • Woodbury, MN
National Provider Identifier
1023317179
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8641 Issued in MN
Practice address
2101 Wooddale Dr Ste a
Woodbury, MN 55125-2933
Phone
(651) 738-9888
NPI assigned
Mar 15, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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 8641 MN Primary

Addresses

Primary practice location

2101 Wooddale Dr Ste a
Woodbury, MN 55125-2933

Mailing address

2101 Wooddale Dr Ste a
Woodbury, MN 55125-2933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110531000539 MN Practitioner - Qualified Speech Language Pathologist 0446437479 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8641MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic, LTD. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1300147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1023317179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 WOODDALE DR STE A",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 WOODDALE DR STE A",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252933",
            "telephone_number": "651-738-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JANA",
        "middle_name": "MARIE",
        "credential": "CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-15",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "8641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.