Active NPI
Katelyn Nichols Smith, MSP, CCC-SLP
- Speech-Language Pathologist
- Charleston, SC
National Provider Identifier
1770037426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 75 Calhoun St
Charleston, SC 29401-3538 - Phone
- (843) 937-6539
- NPI assigned
- Aug 11, 2016
- 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 | Primary |
Addresses
Primary practice location
75 Calhoun St
Charleston, SC 29401-3538
Mailing address
635 Beaten Path
Charleston, SC 29412-2778
Phone (843) 450-8771
Other names 1
- Mrs. Katelyn Nichols
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
800 N Lake Dr
Lexington, SC 29072-2903
Phone (877) 407-3422
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5881 | SC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fox Rehabilitation Services of South Carolina, LLC | Speech-Language Pathologist | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Lexington, SC
- NPI 1902133689
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470873600000",
"number": "1770037426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "635 BEATEN PATH",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294122778",
"telephone_number": "843-450-8771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 CALHOUN ST",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294013538",
"telephone_number": "843-937-6539"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "KATELYN",
"middle_name": "NICHOLS",
"name_prefix": "Mrs.",
"credential": "MSP, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-11",
"last_updated": "2016-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KATELYN",
"last_name": "NICHOLS",
"prefix": "MRS.",
"credential": "MSP, CCC-SLP",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.