Jackie Lea Smith, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP-2161 Issued in WV

Practice address

731 Preston Dr
Kingwood, WV 26537-1545

Phone

(304) 363-7323

Fax

(304) 366-2483

NPI assigned

Feb 10, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1265024392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 LOCUST AVE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265544721",
            "telephone_number": "304-363-7323",
            "fax_number": "304-366-2483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 PRESTON DR",
            "city": "KINGWOOD",
            "state": "WV",
            "postal_code": "265371545",
            "telephone_number": "304-363-7323",
            "fax_number": "304-366-2483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JACKIE",
        "middle_name": "LEA",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-10",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WV",
            "license": "SLP-2161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Ann Slaubaugh, LPN
• Monica Gayle Slaubaugh
• Elizabeth S Smailes, LGSW
• Gloria Smith
• Heather Smith
• Julie Smith
• Madalynn Nicole Mae Smith
• Anne Snyder
• Heidi Lurie Solomon, SLP
• Brian L Spiker, B.S. PHARM

• Speech-Language Pathologist in Kingwood, WV
• Providers in Kingwood, WV by specialty
• Speech-Language Pathologist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.