Melissa Smith, MS CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

839 Issued in NE

Practice address

11850 Nicholas St Ste 200
Omaha, NE 68154

Phone

(402) 577-0496

Fax

(402) 933-4905

NPI assigned

May 23, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Melissa Dodge-Forman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Integrated Pediatric Therapy, LLC

  • Pediatric Occupational Therapist
  • Omaha, NE
  • NPI 1578029872

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550793600000",
    "number": "1043420334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2506 S 127TH CIR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442603",
            "telephone_number": "402-238-6908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11850 NICHOLAS ST STE 200",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68154",
            "telephone_number": "402-577-0496",
            "fax_number": "402-933-4905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8031 W Center Rd",
            "address_2": "Suite 225",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681243158",
            "country_code": "US",
            "telephone_number": "402-391-5002",
            "fax_number": "402-343-1278",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11850 Nicholas St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "68154",
            "country_code": "US",
            "telephone_number": "402-577-0496",
            "fax_number": "402-933-4905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MELISSA",
        "credential": "MS CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2019-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "DODGE-FORMAN",
            "credential": "MS CCC SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary K. Smith, PLMHP
• Megan Marie Smith, APRN -NP
• Melanie Rose Smith, LMHP
• Melany F Smith
• Melissa Smith, CRNA
• Melissa Smith
• Melissa Smith, CSW
• Melissa Smith, PCA, RN
• Melodye Smith
• Meyokia Nicole Smith, APRN

• Speech-Language Pathologist in Omaha, NE
• Providers in Omaha, NE by specialty
• Speech-Language Pathologist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; 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.