Individual provider Active NPI

Kathleen M Smith, CCC-SLP

  • Speech-Language Pathologist
  • Baltimore, MD
National Provider Identifier
1376974402
Registry record updated Nov 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
03129 Issued in MD
Practice address
416 E 30TH St
Baltimore, MD 21218-3934
Phone
(410) 889-0727
Fax
(410) 889-0729
NPI assigned
Nov 27, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 03129 MD Primary

Addresses

Primary practice location

416 E 30TH St
Baltimore, MD 21218-3934

Mailing address

416 E 30TH St
Baltimore, MD 21218-3934
Phone (410) 889-0727

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

LicenseStateTypeSpecialty
03129MDMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1385510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385510400000",
    "number": "1376974402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 E 30TH ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212183934",
            "telephone_number": "410-889-0727",
            "fax_number": "410-889-0729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 E 30TH ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212183934",
            "telephone_number": "410-889-0727",
            "fax_number": "410-889-0729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-27",
        "last_updated": "2013-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "03129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2013; 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.