Active NPI
Amy Smith, CCC-SLP
- Speech-Language Pathologist
- Tidewater, OR
National Provider Identifier
1316569551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 016359
- Practice address
- 8313 E Alsea Hwy
Tidewater, OR 97390-9712 - Phone
- (707) 499-5850
- NPI assigned
- May 11, 2020
- Last updated
- May 11, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 016359 | OR | Primary |
Addresses
Primary practice location
8313 E Alsea Hwy
Tidewater, OR 97390-9712
Mailing address
PO Box 1708
Newport, OR 97365-0126
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 |
|---|---|---|---|
| 016359 | OR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589155200000",
"number": "1316569551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1708",
"city": "NEWPORT",
"state": "OR",
"postal_code": "973650126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8313 E ALSEA HWY",
"city": "TIDEWATER",
"state": "OR",
"postal_code": "973909712",
"telephone_number": "707-499-5850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "AMY",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-05-11",
"last_updated": "2020-05-11",
"certification_date": "2020-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OR",
"license": "016359",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tidewater, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.