Active NPI
Judith R Smitheran, S.T.
- Speech-Language Pathologist
- Santa Fe, NM
National Provider Identifier
1700945896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 827
- Practice address
- 2025 Galisteo St
Santa Fe, NM 87505-2101 - Phone
- (505) 820-5702
- Fax
- (505) 820-5438
- NPI assigned
- Dec 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 827 | NM | Primary |
Addresses
Primary practice location
2025 Galisteo St
Santa Fe, NM 87505-2101
Mailing address
455 Saint Michaels Dr
Santa Fe, NM 87505-7601
Phone (505) 820-5227
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NM00E225 | Other | NM | BCBS NM |
| 69850780 | Medicaid | NM | |
| 10014098 | Other | LOVELACE | |
| 2413409 | Other | UHC | |
| PROVP16194 | Other | MOLINA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 827 | NM | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193788800000",
"number": "1700945896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 SAINT MICHAELS DR",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875057601",
"telephone_number": "505-820-5227",
"fax_number": "505-820-5440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2025 GALISTEO ST",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875052101",
"telephone_number": "505-820-5702",
"fax_number": "505-820-5438"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITHERAN",
"first_name": "JUDITH",
"middle_name": "R",
"credential": "S.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-06",
"last_updated": "2007-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NM",
"license": "827",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS NM",
"identifier": "NM00E225",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "69850780",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LOVELACE",
"identifier": "10014098",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "2413409",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOLINA",
"identifier": "PROVP16194",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.