Edward L Smith Sr.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

S-2758 Issued in MS

Practice address

9127 Corporate Dr
Southaven, MS 38671-1243

Phone

(662) 812-3685

NPI assigned

May 13, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Frog Services LLC.

  • Non-emergency Medical Transport (VAN)
  • Southaven, MS
  • NPI 1013745082
  NPD Authorized official

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

{
    "created_epoch": "1715558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721520000000",
    "number": "1346098480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9127 CORPORATE DR",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386711243",
            "telephone_number": "662-812-3685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9127 CORPORATE DR",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386711243",
            "telephone_number": "662-812-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "EDWARD",
        "middle_name": "L",
        "name_suffix": "Sr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-13",
        "last_updated": "2024-07-21",
        "certification_date": "2024-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S-2758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audrey Lynne Smart, M.S., SLP
• Alan Charles Smith, O.D.
• Alison Edge Smith, MSN, PMHNP
• Catherine Ruth Smith, APN
• Chaniqua Dominique Smith, PMHNP-BC
• Gabrielle Smith, HIS
• Johnella Smith
• Lashay Smith
• Lauren Smith, FNP
• Matthew W Smith, PT

• Speech-Language Pathologist in Southaven, MS
• Providers in Southaven, MS by specialty
• Speech-Language Pathologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2024; 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.