Active NPI
Lucy Diane Smith, MS CCC-SLP
- Speech-Language Pathologist
- Hattiesburg, MS
National Provider Identifier
1215349238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- S3637
- Practice address
- 4805 W 4TH St
Hattiesburg, MS 39402-1019 - Phone
- (601) 270-6968
- NPI assigned
- May 25, 2014
- Sex
- Female
- Sole proprietor
- No
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 | S3637 | MS | Primary |
Addresses
Primary practice location
4805 W 4TH St
Hattiesburg, MS 39402-1019
Mailing address
713 Morris Tullos Dr
Morton, MS 39117-3110
Phone (601) 606-8006
Other practice location 1
103 Briarcliff Dr
Hattiesburg, MS 39402-1922
Phone (601) 940-6412
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 |
|---|---|---|---|
| S3637 | MS | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aultman Speech Therapy Services, LLC | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Speech-Language Pathologist
- Sumrall, MS
- NPI 1912154220
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571356800000",
"number": "1215349238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "713 MORRIS TULLOS DR",
"city": "MORTON",
"state": "MS",
"postal_code": "391173110",
"telephone_number": "601-606-8006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4805 W 4TH ST",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394021019",
"telephone_number": "601-270-6968"
}
],
"practiceLocations": [
{
"address_1": "103 Briarcliff Dr",
"address_purpose": "LOCATION",
"city": "Hattiesburg",
"state": "MS",
"postal_code": "394021922",
"country_code": "US",
"telephone_number": "601-940-6412",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SMITH",
"first_name": "LUCY",
"middle_name": "DIANE",
"credential": "MS CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-25",
"last_updated": "2019-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MS",
"license": "S3637",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hattiesburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.