Marybeth Smith, CCC-SLP, M.A.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

01094154 Issued in MI

Practice address

1101 Health Professions Building
Mt Pleasant, MI 48859-0001

Phone

(989) 774-2877

Fax

(989) 774-1891

NPI assigned

Sep 20, 2007

Sex

Female

Sole proprietor

No

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

Credentials

Master of Arts

State licenses

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.

• Central Michigan University

  • Family Medicine Physician
  • Mt Pleasant, MI
  • NPI 1487686754
  NPD (past)

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1740476092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 HEALTH PROFESSIONS BUILDING",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488590001",
            "telephone_number": "989-774-2877",
            "fax_number": "989-774-1891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 HEALTH PROFESSIONS BUILDING",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488590001",
            "telephone_number": "989-774-2877",
            "fax_number": "989-774-1891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARYBETH",
        "credential": "CCC-SLP, M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "01094154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA NUMBER",
            "identifier": "01094154",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamie Smith
• Jasmine Ayanna Smith
• Jody Lyn Smith, MSW LLMSW CDP CAADC
• Karlyn Smith
• Lisa Ann Smith
• Misty Lynne Smith, MS, LLPC
• Natalie Morgan Smith
• Shannon Leigh Smith, AUD
• Skylar Smith
• Stefanie S Smith, LMSW

• Speech-Language Pathologist in Mt Pleasant, MI
• Providers in Mt Pleasant, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.

Verify at the official NPI Registry.