Samantha Mehta

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

41YS00715600 Issued in NJ

Practice address

47 Coachlight Dr
Sicklerville, NJ 08081-5606

Phone

(609) 220-6421

NPI assigned

May 29, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Ultima Rehab-NJ LLC

  • Geriatric Physical Therapist
  • Wall Township, NJ
  • NPI 1427426485

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401321600000",
    "number": "1730591470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 COACHLIGHT DR",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080815606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 COACHLIGHT DR",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080815606",
            "telephone_number": "609-220-6421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "SAMANTHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-29",
        "last_updated": "2014-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00715600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS PERSONAL CHOICE",
            "identifier": "TQJ4047604901",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deztiny McLaughlin
• Sierra Aaliyah McLean
• Katherine McMackin, M.D.
• Tadyanna McShan
• MDF Sicklerville LLC
• Melody Jobs Premier Staffing
• Paul Menno Jr.
• Jonathan Merceus
• Kelly Lynn Messina, RPH
• Emeka Mgbemena

• Speech-Language Pathologist in Sicklerville, NJ
• Providers in Sicklerville, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2014; 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.