Active NPI
Samantha Barksdale, M.S., CF-SLP
- Speech-Language Pathologist
- Foxworth, MS
National Provider Identifier
1104233840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- S3869
- Practice address
- 285 Holmes Pittman Rd
Foxworth, MS 39483-3166 - Phone
- (601) 736-3111
- Fax
- (601) 444-5036
- NPI assigned
- Jul 15, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | S3869 | MS | Primary |
Addresses
Primary practice location
285 Holmes Pittman Rd
Foxworth, MS 39483-3166
Mailing address
285 Holmes Pittman Rd
Foxworth, MS 39483-3166
Phone (601) 736-3111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| S3869 | Other | MS | MISSISSIPPI STATE BOARD OF HEALTH LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| S3869 | MS | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405382400000",
"number": "1104233840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "285 HOLMES PITTMAN RD",
"city": "FOXWORTH",
"state": "MS",
"postal_code": "394833166",
"telephone_number": "601-736-3111",
"fax_number": "601-444-5036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "285 HOLMES PITTMAN RD",
"city": "FOXWORTH",
"state": "MS",
"postal_code": "394833166",
"telephone_number": "601-736-3111",
"fax_number": "601-444-5036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARKSDALE",
"first_name": "SAMANTHA",
"credential": "M.S., CF-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-15",
"last_updated": "2014-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MS",
"license": "S3869",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MISSISSIPPI STATE BOARD OF HEALTH LICENSE",
"identifier": "S3869",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Foxworth, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.