Individual provider Active NPI

Samantha Lynn Smith

  • Speech-Language Pathologist
  • Franklin Square, NY
National Provider Identifier
1649765033
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1231263181 Issued in NY
Practice address
560 Nassau Blvd
Franklin Square, NY 11010-4337
Phone
(516) 505-6955
NPI assigned
Jun 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

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 1231263181 NY Primary

Addresses

Primary practice location

560 Nassau Blvd
Franklin Square, NY 11010-4337

Mailing address

272 17TH St
West Babylon, NY 11704-2726
Phone (631) 455-9719

Other practice location 1

77 Church St
Malverne, NY 11565-1726
Phone (516) 495-4898

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

State licenses

LicenseStateTypeSpecialty
1231263181NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Malverne Center for Play and Development Past Accepting new patients
The Kid Spot for Speech, Physical, and Occupational Therapy, PLLC PastSince Feb 6, 2022 Accepting new patients

Organizations & group practices 2

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": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1649765033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 17TH ST",
            "city": "WEST BABYLON",
            "state": "NY",
            "postal_code": "117042726",
            "telephone_number": "631-455-9719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 NASSAU BLVD",
            "city": "FRANKLIN SQUARE",
            "state": "NY",
            "postal_code": "110104337",
            "telephone_number": "516-505-6955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 Church St",
            "address_purpose": "LOCATION",
            "city": "Malverne",
            "state": "NY",
            "postal_code": "115651726",
            "country_code": "US",
            "telephone_number": "516-495-4898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SAMANTHA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "1231263181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin Square, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; 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.