Samantha Kay Sudduth

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2021019476 Issued in MO

Practice address

1881 Pine St
Saint Louis, MO 63103-2264

Phone

(314) 533-0975

NPI assigned

Aug 27, 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

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.

• St Louis Lang Immersion School

  • Local Education Agency (LEA)
  • Saint Louis, MO
  • NPI 1164838850
  NPD (past)

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

{
    "created_epoch": "1630022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1285301036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 PAPIN ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 PINE ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631032264",
            "telephone_number": "314-533-0975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDDUTH",
        "first_name": "SAMANTHA",
        "middle_name": "KAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-27",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2021019476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Gerard Sucher I, M.D.
• Kathleen Suda, RN-PLPC
• Kavya Sudanagunta, MD
• Ebony Cassandra Sudduth, DNP, PMHNP-BC
• Rebecca Sudduth
• Taylor Sudduth
• Sean Nicole Sudekum
• Deepti Sudhakar
• Santosh Sudhakar, MD
• Deepu Sudhakaran, M.D

• Speech-Language Pathologist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.