Individual provider Active NPI

Noah Thomas Smothers, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Panama City, FL
National Provider Identifier
1255050928
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA21346 Issued in FL
Practice address
4800 N Star Ave
Panama City, FL 32404
Phone
(850) 329-0796
NPI assigned
Aug 25, 2022
Reactivated
Oct 31, 2024
Last updated
Oct 31, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 5365 AL
Speech-Language Pathologist 235Z00000X AL
Speech-Language Pathologist 235Z00000X SA21346 FL Primary

Addresses

Primary practice location

4800 N Star Ave
Panama City, FL 32404

Mailing address

4800 N Star Ave
Panama City, FL 32404-9333
Phone (850) 329-0796

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

LicenseStateTypeSpecialty
5365ALMDRegistered Dietitian
SA21346FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Caresouth HHA Holdings of Panama City, LLC PastSince May 1, 2023 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1255050928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N STAR AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324049333",
            "telephone_number": "850-329-0796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 N STAR AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "32404",
            "telephone_number": "850-329-0796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOTHERS",
        "first_name": "NOAH",
        "middle_name": "THOMAS",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-25",
        "last_updated": "2024-10-31",
        "certification_date": "2023-05-23",
        "deactivation_date": "2024-01-22",
        "reactivation_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AL",
            "license": "5365",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AL",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA21346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.