Individual provider Active NPI

Samantha Sue McSherry, MA, CCC/SLP

  • Speech-Language Pathologist
  • Roswell, GA
National Provider Identifier
1811240864
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP004914 Issued in GA
Practice address
265 Merritt Dr
Roswell, GA 30076-3937
Phone
(678) 461-7568
NPI assigned
Oct 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

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 SLP004914 GA Primary

Addresses

Primary practice location

265 Merritt Dr
Roswell, GA 30076-3937

Mailing address

265 Merritt Dr
Roswell, GA 30076-3937
Phone (678) 461-7568

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SLP004914GAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1811240864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 MERRITT DR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300763937",
            "telephone_number": "678-461-7568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 MERRITT DR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300763937",
            "telephone_number": "678-461-7568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCSHERRY",
        "first_name": "SAMANTHA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-16",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP004914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; 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.