Samantha Renee Minich, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

22008951A Issued in IN

Practice address

5154 N Park Ave
Indianapolis, IN 46205-1066

Phone

(260) 223-5350

NPI assigned

Jul 12, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Samantha Renee Fisher Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Fox Rehab Indiana LLC

  • Physical Therapist
  • Cherry Hill, NJ
  • NPI 1043568942

  IN, Speech-Language Pathologist

  Medicare reassignment NPD
• Chrysalis Orofacial

  • Speech-Language Pathologist
  • Greenville, SC
  • NPI 1891317004
  NPD

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

{
    "created_epoch": "1562889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734998400000",
    "number": "1346892007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5154 N PARK AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462051066",
            "telephone_number": "260-223-5350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5154 N PARK AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462051066",
            "telephone_number": "260-223-5350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINICH",
        "first_name": "SAMANTHA",
        "middle_name": "RENEE",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-12",
        "last_updated": "2024-12-24",
        "certification_date": "2024-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22008951A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTH CAROLINA SLP LICENSE",
            "identifier": "7928",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "samantha@chrysalisorofacial.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "302A Ashby Park Ln",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296076903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab Indiana LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "14901 Carey Rd",
            "city": "Carmel",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460336000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "FISHER",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mini Milestones, LLC
• Amber Jeanette Miniard
• Julie Ann Minich, MAT CCC SLP
• Mariah Minich, RBT
• Meredith Minich, M.A. CCC SLP
• Lanya Minion
• Sherry J Minkis, D.C.
• Divya Minnaganti, MD
• Kimberly Minner
• Jason Adam Minnich II

• Speech-Language Pathologist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Speech-Language Pathologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2024; 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.