Mackenzie Anne Smith

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

17517 Issued in IL

Practice address

220 NE Norton LN
McMinnville, OR 97128-8470

Phone

(503) 883-8250

Fax

(888) 835-4257

NPI assigned

Nov 30, 2018

Last updated

May 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sensible Speech-Language Pathology, Inc

  • Speech-Language Pathologist
  • Salem, OR
  • NPI 1144645102
  Medicare reassignment NPD

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

{
    "created_epoch": "1543536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1629548714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2053 N SHEFFIELD AVE APT 4F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606147424",
            "telephone_number": "815-245-1435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 NE NORTON LN",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971288470",
            "telephone_number": "503-883-8250",
            "fax_number": "888-835-4257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MACKENZIE",
        "middle_name": "ANNE",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-30",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "17517",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Jolyn Smith
• Janina Smith, LCSW
• Jillien Elizabeth Smith
• Kari Smith
• Linda Smith
• Mark Kenneth Smith
• Matthew Smith
• Morgan Smith, MSW
• Teresa Ailynn Smith, RPH
• Dana Ann Smothers, RN

• Speech-Language Pathologist in McMinnville, OR
• Providers in McMinnville, OR by specialty
• Speech-Language Pathologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.