Active NPI
Kerry Smith, SLP
- Speech-Language Pathologist
- Havelock, NC
National Provider Identifier
1316723612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 3318
- Practice address
- 110 McCotter Blvd
Havelock, NC 28532-1632 - Phone
- (252) 444-4631
- NPI assigned
- Sep 4, 2023
- 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 | 3318 | NC | Primary |
Addresses
Primary practice location
110 McCotter Blvd
Havelock, NC 28532-1632
Mailing address
2600 Compass Rd
Glenview, IL 60026-8001
Phone (877) 787-3430
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 |
|---|---|---|---|
| 3318 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693785600000",
"number": "1316723612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2600 COMPASS RD",
"city": "GLENVIEW",
"state": "IL",
"postal_code": "600268001",
"telephone_number": "877-787-3430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 MCCOTTER BLVD",
"city": "HAVELOCK",
"state": "NC",
"postal_code": "285321632",
"telephone_number": "252-444-4631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "KERRY",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-04",
"last_updated": "2023-09-04",
"certification_date": "2023-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "3318",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Havelock, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.