Individual provider Active NPI

Caroline Sammons, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Fernley, NV
National Provider Identifier
1063054914
Registry record updated Oct 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP-2589 Issued in NV
Practice address
245 Mary Lou LN
Fernley, NV 89408-5619
Phone
(716) 380-1508
NPI assigned
Oct 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP-25290 CA
Speech-Language Pathologist 235Z00000X SP-2589 NV Primary

Addresses

Primary practice location

245 Mary Lou LN
Fernley, NV 89408-5619

Mailing address

245 Mary Lou LN
Fernley, NV 89408-5619
Phone (716) 380-1508

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 Science

State licenses

LicenseStateTypeSpecialty
SP-25290CAMDSpeech-Language Pathologist
SP-2589NVMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1063054914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 MARY LOU LN",
            "city": "FERNLEY",
            "state": "NV",
            "postal_code": "894085619",
            "telephone_number": "716-380-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 MARY LOU LN",
            "city": "FERNLEY",
            "state": "NV",
            "postal_code": "894085619",
            "telephone_number": "716-380-1508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMMONS",
        "first_name": "CAROLINE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-11",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP-25290",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NV",
            "license": "SP-2589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fernley, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.