Individual provider Active NPI

Wanda Lockaby Smith, MA.ED. CCC/SLP

  • Speech-Language Pathologist
  • London, KY
National Provider Identifier
1073475570
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
139065 Issued in KY
Practice address
710 N Main St
London, KY 40741-1222
Phone
(606) 862-4608
NPI assigned
Dec 2, 2025
Last updated
Dec 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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 139065 KY Primary

Addresses

Primary practice location

710 N Main St
London, KY 40741-1222

Mailing address

264 Derby Dr
London, KY 40744-6474
Phone (606) 224-4828

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

State licenses

LicenseStateTypeSpecialty
139065KYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1764633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1073475570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 DERBY DR",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407446474",
            "telephone_number": "606-224-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 N MAIN ST",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407411222",
            "telephone_number": "606-862-4608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "WANDA",
        "middle_name": "LOCKABY",
        "name_prefix": "Mrs.",
        "credential": "MA.ED. CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-02",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "139065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in London, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; 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.