Jennifer Smith, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202005153 Issued in VA

Practice address

3610 Winchester Dr
Portsmouth, VA 23707-4330

Phone

(757) 397-0725

NPI assigned

Jan 22, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1611273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1376133355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1536 SELDEN ST",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234541734",
            "telephone_number": "757-714-5559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 WINCHESTER DR",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237074330",
            "telephone_number": "757-397-0725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JENNIFER",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-22",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202005153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Faith Smith, RN
• Christopher S Smith, M.D.
• Edward Smith, MT
• Emma Smith
• Eric NMN Smith
• Jinnifer Smith
• Katara Lynn Smith, MSW QMHP-A QMHP-C
• Kellen Matthew Smith, DPT
• Kenneth Andrew Smith, DO
• Lawona S Smith, RN

• Speech-Language Pathologist in Portsmouth, VA
• Providers in Portsmouth, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.