Individual provider Active NPI

Sarah Martin, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Lees Summit, MO
National Provider Identifier
1215322896
Registry record updated Apr 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2014028753 Issued in MO
Practice address
301 NE Tudor Rd
Lees Summit, MO 64086-5702
Phone
(816) 986-3175
NPI assigned
Apr 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2015

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 2014028753 MO Primary

Addresses

Primary practice location

301 NE Tudor Rd
Lees Summit, MO 64086-5702

Mailing address

301 NE Tudor Rd
Lees Summit, MO 64086-5702
Phone (816) 986-3175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181121001460 MO Practitioner - Qualified Speech Language Pathologist 1850645219 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Speech-Language Pathologist CurrentSince Oct 10, 2018 Accepting new patients
Aegis Group Practice LLC Speech-Language Pathologist CurrentSince Oct 10, 2018 Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

1131 E Lakewood St
Springfield, MO 65810
Phone (417) 429-3666

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": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427846400000",
    "number": "1215322896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 NE TUDOR RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865702",
            "telephone_number": "816-986-3175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 NE TUDOR RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865702",
            "telephone_number": "816-986-3175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SARAH",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-01",
        "last_updated": "2015-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2014028753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.