Individual provider Active NPI

Mary Kate Smith, MA CCC SLP

  • Speech-Language Pathologist
  • Baton Rouge, LA
National Provider Identifier
1124643846
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
18268 Petroleum Dr
Baton Rouge, LA 70809-6126
Phone
(225) 292-4138
Fax
(225) 636-2940
NPI assigned
Jun 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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 LA Primary

Addresses

Primary practice location

18268 Petroleum Dr
Baton Rouge, LA 70809-6126

Mailing address

17732 Highland Rd., Ste G, Box 243
Baton Rouge, LA 70810-3813
Phone (225) 292-4138

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 Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Abilities Pediatric Therapy Clinic Speech-Language Pathologist CurrentSince Aug 30, 2020 Accepting new patients
Listening Earfects Speech-Language Pathologist PastSince Jun 14, 2020 Accepting new patients

Locations

17732 Highland Rd
Ste G
Baton Rouge, LA 70810

18268 Petroleum Dr
Baton Rouge, LA 70809
Phone (225) 292-4138

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1124643846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17732 HIGHLAND RD., STE G, BOX 243",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708103813",
            "telephone_number": "225-292-4138",
            "fax_number": "225-636-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18268 PETROLEUM DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708096126",
            "telephone_number": "225-292-4138",
            "fax_number": "225-636-2940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARY",
        "middle_name": "KATE",
        "credential": "MA CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-09",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.