Individual provider Active NPI

Samantha Stone Wilson, M.S., CF-SLP

  • Speech-Language Pathologist
  • Indianapolis, IN
National Provider Identifier
1740839216
Registry record updated Sep 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
6239 S East St Ste a
Indianapolis, IN 46227-2088
Phone
(317) 791-9031
Fax
(317) 791-9001
NPI assigned
Sep 8, 2019
Last updated
Sep 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2019

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 IN Primary

Addresses

Primary practice location

6239 S East St Ste a
Indianapolis, IN 46227-2088

Mailing address

6239 S East St Ste a
Indianapolis, IN 46227-2088
Phone (317) 791-9031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210810001701 IN Practitioner - Qualified Speech Language Pathologist 7416351663 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
CHN JMH Ventures LLC CurrentSince Aug 1, 2021 Accepting new patients
CHN JMH Ventures LLC Speech-Language Pathologist CurrentSince Aug 1, 2021 Accepting new patients
Pediplay LLC PastSince Sep 15, 2019 Accepting new patients

Locations

7598 Solutions Ctr
Chicago, IL 60677

3000 S State Road 135
Greenwood, IN 46143
Phone (317) 497-6000

3000 S State Road 135
Ste 110
Greenwood, IN 46143
Phone (317) 497-6000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1567900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567900800000",
    "number": "1740839216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6239 S EAST ST STE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462272088",
            "telephone_number": "317-791-9031",
            "fax_number": "317-791-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6239 S EAST ST STE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462272088",
            "telephone_number": "317-791-9031",
            "fax_number": "317-791-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SAMANTHA",
        "middle_name": "STONE",
        "name_prefix": "Mrs.",
        "credential": "M.S., CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-08",
        "last_updated": "2019-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.