Susan Michelle Siddiqui, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

6915 Issued in TN

Practice address

530 Mulberry Ave
Selmer, TN 38375-2423

Phone

(423) 622-1551

NPI assigned

Sep 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1093813636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16305 LAND DR",
            "city": "HARVEST",
            "state": "AL",
            "postal_code": "357497353",
            "telephone_number": "256-233-1166",
            "fax_number": "256-852-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 MULBERRY AVE",
            "city": "SELMER",
            "state": "TN",
            "postal_code": "383752423",
            "telephone_number": "423-622-1551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "245 Cahaba Valley Pkwy",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Pelham",
            "state": "AL",
            "postal_code": "351242216",
            "country_code": "US",
            "telephone_number": "205-942-6820 x1145",
            "fax_number": "205-942-5627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "SUSAN",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "6915",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AL",
            "license": "2403",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Sain, BS
• Selmer Smiles
• Selmer SNF Healthcare LLC
• William G Shelton, MOTR/L
• Mary Beth Shirley, PA
• Erin Paige Simpson, PHARM.D.
• Skyline Eye Clinic, PC
• James Preston Smith, OD
• Jeri Smith, LMT
• Trista Lavonne Smith, OT

• All providers in Selmer, TN
• Speech-Language Pathologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; 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.