Individual provider Active NPI

Laura Williams Smith, MS-CCC/SLP

  • Speech-Language Pathologist
  • Maryville, TN
National Provider Identifier
1306497037
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7359 Issued in TN
Practice address
2030 Chilhowee Medical Park
Maryville, TN 37804-5285
Phone
(865) 982-3400
Fax
(865) 238-2034
NPI assigned
Sep 24, 2019
Last updated
Oct 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2903 AL
Speech-Language Pathologist 235Z00000X 7359 TN Primary

Addresses

Primary practice location

2030 Chilhowee Medical Park
Maryville, TN 37804-5285

Mailing address

PO Box 5209
Maryville, TN 37802-5209
Phone (865) 982-3400

Other practice location 1

2703 University Blvd E
Tuscaloosa, AL 35404-3226
Phone (205) 248-7064

Other identifiers 1

IdentifierTypeStateIssuer
Q061279MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191108002896 AL Practitioner - Qualified Speech Language Pathologist 2062844202 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7359TNMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Hope LLC Speech-Language Pathologist CurrentSince Sep 23, 2019 Accepting new patients
Little Tennessee Valley Educational Cooperative PastSince Nov 1, 2020 Accepting new patients
Speech Pathology Services of East Tennessee LLC Speech-Language Pathologist PastSince Nov 1, 2020 Accepting new patients

Locations

1502 Main St
Greensboro, AL 36744
Phone (205) 575-1609

2703 University Blvd E
Tuscaloosa, AL 35404
Phone (205) 248-7064

Organizations & group practices 3

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": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1306497037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5209",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378025209",
            "telephone_number": "865-982-3400",
            "fax_number": "865-238-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 CHILHOWEE MEDICAL PARK",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045285",
            "telephone_number": "865-982-3400",
            "fax_number": "865-238-2034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2703 University Blvd E",
            "address_purpose": "LOCATION",
            "city": "Tuscaloosa",
            "state": "AL",
            "postal_code": "354043226",
            "country_code": "US",
            "telephone_number": "205-248-7064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LAURA",
        "middle_name": "WILLIAMS",
        "name_prefix": "Mrs.",
        "credential": "MS-CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-24",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AL",
            "license": "2903",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "7359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q061279",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.