Individual provider Active NPI

Suzann Michelle Patterson, SLP

  • Speech-Language Pathologist
  • Tupelo, MS
National Provider Identifier
1376705228
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
S-5183 Issued in MS
Practice address
960 Commonwealth Blvd
Tupelo, MS 38804-9762
Phone
(662) 260-3789
NPI assigned
Jul 1, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X S-5183 MS Primary

Addresses

Primary practice location

960 Commonwealth Blvd
Tupelo, MS 38804-9762

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7217

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241121002375 MS Practitioner - Qualified Speech Language Pathologist 8628503091 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S-5183MSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy of Mississippi LLC Multi-Specialty CurrentSince Oct 7, 2024 Accepting new patients
Dpti Elite Physical Therapy LLC Multi-Specialty CurrentSince Oct 7, 2024 Accepting new patients
Drayer Physical Therapy Mississippi LLC Multi-Specialty CurrentSince Oct 7, 2024 Accepting new patients
Dpti Elite Physical Therapy LLC Multi-Specialty CurrentSince Oct 7, 2024 Accepting new patients
Agilitas USA, Inc CurrentSince Oct 7, 2024 Accepting new patients
Agilitas USA Inc Multi-Specialty CurrentSince Oct 7, 2024 Accepting new patients
Advance Rehabilitation Services, Inc. Multi-Specialty Past Accepting new patients
Drayer Physical Therapy Mississippi LLC Multi-Specialty Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

117 Bo Bo Dr
Crystal Springs, MS 39059
Phone (601) 892-6330

4010 Bienville Blvd
Unit E
Ocean Springs, MS 39564
Phone (228) 300-6001

2319 Highway 145
Saltillo, MS 38866
Phone (662) 869-9980

3451 Goodman Rd E
Ste 108
Southaven, MS 38672
Phone (662) 253-9060

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1376705228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 COMMONWEALTH BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388049762",
            "telephone_number": "662-260-3789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "SUZANN",
        "middle_name": "MICHELLE",
        "name_prefix": "Miss",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-01",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S-5183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.