Active NPI
Stephany Michelle Rosaly Sampoll
- Speech-Language Pathologist
- Ponce, PR
National Provider Identifier
1306454608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4124
- Practice address
- 1349 Calle Salud Ste 4
Ponce, PR 00717-2017 - Phone
- (787) 290-4000
- NPI assigned
- Jul 22, 2020
- 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 | 4124 | PR | Primary |
Addresses
Primary practice location
1349 Calle Salud Ste 4
Ponce, PR 00717-2017
Mailing address
1349 Calle Salud Ste 4
Ponce, PR 00717-2017
Phone (787) 290-4000
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4124 | PR | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mo Therapy Center | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595376000000",
"number": "1306454608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1349 CALLE SALUD STE 4",
"city": "PONCE",
"state": "PR",
"postal_code": "007172017",
"telephone_number": "787-290-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1349 CALLE SALUD STE 4",
"city": "PONCE",
"state": "PR",
"postal_code": "007172017",
"telephone_number": "787-290-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSALY SAMPOLL",
"first_name": "STEPHANY",
"middle_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-22",
"last_updated": "2020-07-22",
"certification_date": "2020-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "PR",
"license": "4124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponce, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.