Individual provider Active NPI

Jeanmarie Smith, MS,CCC-SLP

  • Speech-Language Pathologist
  • Tuscaloosa, AL
National Provider Identifier
1629381850
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5141 Issued in AL
Practice address
2703 University Blvd E
Tuscaloosa, AL 35404-3226
Phone
(205) 248-7064
NPI assigned
Jul 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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 5141 AL Primary

Addresses

Primary practice location

2703 University Blvd E
Tuscaloosa, AL 35404-3226

Mailing address

2703 University Blvd E
Tuscaloosa, AL 35404-3226
Phone (205) 248-7064

Other practice location 1

112 Grove Ave
Elroy, WI 53929-1513
Phone (808) 208-3249

Other practice location 2

84-203 Water St
Waianae, HI 96792-1839
Phone (808) 294-9110

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
5141ALMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1629381850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2703 UNIVERSITY BLVD E",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354043226",
            "telephone_number": "205-248-7064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2703 UNIVERSITY BLVD E",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354043226",
            "telephone_number": "205-248-7064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 Grove Ave",
            "address_purpose": "LOCATION",
            "city": "Elroy",
            "state": "WI",
            "postal_code": "539291513",
            "country_code": "US",
            "telephone_number": "808-208-3249",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "84-203 Water St",
            "address_purpose": "LOCATION",
            "city": "Waianae",
            "state": "HI",
            "postal_code": "967921839",
            "country_code": "US",
            "telephone_number": "808-294-9110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JEANMARIE",
        "name_prefix": "Mrs.",
        "credential": "MS,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-16",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AL",
            "license": "5141",
            "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 Oct 19, 2022; 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.