Individual provider Active NPI

Samantha Gumula, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Greenville, SC
National Provider Identifier
1497482004
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8778 Issued in SC
Practice address
343 Prado Way
Greenville, SC 29607-6512
Phone
(864) 270-8647
NPI assigned
Aug 3, 2022
Reactivated
Sep 8, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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 8778 SC Primary

Addresses

Primary practice location

343 Prado Way
Greenville, SC 29607-6512

Mailing address

1405 Leaning Tower CT
Simpsonville, SC 29680-7588
Phone (561) 767-1665

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
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Fundamental Communications Speech-Language Pathologist CurrentSince Sep 14, 2025 Accepting new patients

Locations

343 Prado Way
Greenville, SC 29607
Phone (864) 270-8647

Organizations & group practices 1

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": "1659484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1497482004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 LEANING TOWER CT",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296807588",
            "telephone_number": "561-767-1665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 PRADO WAY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296076512",
            "telephone_number": "864-270-8647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMULA",
        "first_name": "SAMANTHA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-03",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "deactivation_date": "2024-07-28",
        "reactivation_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "8778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.