Individual provider Active NPI

Holly Routh Smith, MA, CCC-SLP

  • Speech-Language Pathologist
  • Mooresville, NC
National Provider Identifier
1689648289
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
6812 Issued in NC
Practice address
484 Williamson Rd Ste 102
Mooresville, NC 28117-8191
Phone
(704) 746-9698
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

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 6812 NC Primary

Addresses

Primary practice location

484 Williamson Rd Ste 102
Mooresville, NC 28117-8191

Mailing address

484 Williamson Rd Ste 102
Mooresville, NC 28117-8191
Phone (704) 746-9688

Other practice location 1

364 S Hwy 16
Ste 100
Stanley, NC 28164
Phone (704) 746-9698

Other identifiers 1

IdentifierTypeStateIssuer
7412424MedicaidNC

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 Arts

State licenses

LicenseStateTypeSpecialty
6812NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Norman Communication Services, Inc. Speech-Language Pathologist CurrentSince May 26, 2024 Accepting new patients
Speakability, Inc. Speech-Language Pathologist Past Accepting new patients

Locations

484 Williamson Rd
Ste 102
Mooresville, NC 28117
Phone (704) 293-6552

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1689648289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 WILLIAMSON RD STE 102",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178191",
            "telephone_number": "704-746-9688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 WILLIAMSON RD STE 102",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178191",
            "telephone_number": "704-746-9698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "364 S Hwy 16",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Stanley",
            "state": "NC",
            "postal_code": "28164",
            "country_code": "US",
            "telephone_number": "704-746-9698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "HOLLY",
        "middle_name": "ROUTH",
        "name_prefix": "Ms.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "6812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7412424",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; 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.