Mary Kathleen Smith

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA6063

Practice address

350 Braden Ave
Sarasota, FL 34243-2001

Phone

(941) 355-7637

Fax

(941) 444-2271

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Easterseals of Southwest Florida, Inc

  • Clinic/Center
  • Sarasota, FL
  • NPI 1396890422
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1144339409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 BRADEN AVE",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342432001",
            "telephone_number": "941-355-7637",
            "fax_number": "941-444-2271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 BRADEN AVE",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342432001",
            "telephone_number": "941-355-7637",
            "fax_number": "941-444-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARY",
        "middle_name": "KATHLEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": "SA6063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "887237600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lagen Celeste Smith, PHARMD
• Laura Deanne Smith, OTR
• Leslie Smith, M.A., BCBA
• Lester Ray Smith
• Lori K Smith, RPH
• Memory Smith, NP
• Michael Alexander Smith, PA-C
• Nancy Smith
• Natalie Smith, APRN
• Natalie Smith

• Speech-Language Pathologist in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2021; 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.