Individual provider Active NPI

Laken Smith, MS, CFY-SLP

  • Speech-Language Pathologist
  • Poplarville, MS
National Provider Identifier
1609313642
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
S4271 Issued in MS
Practice address
9 Balmoral Dr
Poplarville, MS 39470-3344
Phone
(601) 795-2043
NPI assigned
Jan 29, 2017
Last updated
May 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2021

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 S4271 MS Primary

Addresses

Primary practice location

9 Balmoral Dr
Poplarville, MS 39470-3344

Mailing address

9 Balmoral Dr
Poplarville, MS 39470-3344
Phone (601) 795-2043

Other practice location 1

4700 Hardy St Ste J1
Hattiesburg, MS 39402-1300
Phone (601) 336-5236

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210427000699 MS Practitioner - Qualified Speech Language Pathologist 2365850641 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
S4271MSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy Mississippi LLC Speech-Language Pathologist CurrentSince May 3, 2021 Accepting new patients
Dpti Elite Physical Therapy LLC Speech-Language Pathologist PastSince May 3, 2021 Accepting new patients
Lambert Therapy Services Speech-Language Pathologist Past Accepting new patients
Drayer Physical Therapy Mississippi LLC 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

4700 Hardy St
Ste J1
Hattiesburg, MS 39402
Phone (601) 336-5236

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1485648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1609313642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 BALMORAL DR",
            "city": "POPLARVILLE",
            "state": "MS",
            "postal_code": "394703344",
            "telephone_number": "601-795-2043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 BALMORAL DR",
            "city": "POPLARVILLE",
            "state": "MS",
            "postal_code": "394703344",
            "telephone_number": "601-795-2043"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Hardy St Ste J1",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394021300",
            "country_code": "US",
            "telephone_number": "601-336-5236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LAKEN",
        "credential": "MS, CFY-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-29",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S4271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplarville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.