Individual provider Active NPI

Mary Catherine Smith

  • Speech-Language Pathologist
  • Tuscaloosa, AL
National Provider Identifier
1477912277
Registry record updated Feb 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
112110 Issued in TX
Practice address
3028 Sagefield Rd
Tuscaloosa, AL 35405-9475
Phone
(205) 344-1852
NPI assigned
Feb 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2016

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 112110 TX Primary

Addresses

Primary practice location

3028 Sagefield Rd
Tuscaloosa, AL 35405-9475

Mailing address

3028 Sagefield Rd
Tuscaloosa, AL 35405-9475
Phone (205) 344-1852

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240419002966 OR Practitioner - Qualified Speech Language Pathologist 0840639092 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
112110TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab Specialists Outpatient, LLC Speech-Language Pathologist CurrentSince Apr 1, 2024 Accepting new patients
Rehab Specialists Outpatient, LLC Speech-Language Pathologist Current Accepting new patients
Rehab Specialists Outpatient, LLC Speech-Language Pathologist CurrentSince Apr 1, 2024 Accepting new patients

Locations

4560 SE International Way
Ste 100
Portland, OR 97222
Phone (971) 206-5129

1417 SE 107th Ave
Portland, OR 97216
Phone (503) 408-0404

Organizations & group practices 3

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": "1456099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1477912277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3028 SAGEFIELD RD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354059475",
            "telephone_number": "205-344-1852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3028 SAGEFIELD RD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354059475",
            "telephone_number": "205-344-1852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARY CATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-22",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "112110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; 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.