Individual provider Active NPI

Samantha Wilkin, SLP

  • Speech-Language Assistant
  • Bainbridge, GA
National Provider Identifier
1861457608
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SLP003555 Issued in GA
Practice address
713 E Shotwell St
Bainbridge, GA 39819-4063
Phone
(229) 246-4088
Fax
(229) 243-0200
NPI assigned
Apr 17, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SLP003555 GA Primary

Addresses

Primary practice location

713 E Shotwell St
Bainbridge, GA 39819-4063

Mailing address

713 E Shotwell St
Bainbridge, GA 39819-4063
Phone (229) 246-4088

Other identifiers 1

IdentifierTypeStateIssuer
00677531AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161208001409 GA Practitioner - Qualified Speech Language Pathologist 4688954654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Speech Therapy Services, P. C.Group PAC ID 4688954639, 2 clinicians

Practice addresses (Care Compare)

502 S Wheat Ave
Bainbridge, GA 39819-4325

502 Wheat Ave
Bainbridge, GA 39819-4325
Phone (229) 246-4088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SLP003555GAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Speech Therapy Services, P. C. CurrentSince Nov 28, 2016 Accepting new patients
Regional Therapy Services Inc Past Accepting new patients

Locations

502 Wheat Ave
Bainbridge, GA 39819
Phone (229) 243-1045

Organizations & group practices 2

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1861457608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 E SHOTWELL ST",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194063",
            "telephone_number": "229-246-4088",
            "fax_number": "229-243-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 E SHOTWELL ST",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194063",
            "telephone_number": "229-246-4088",
            "fax_number": "229-243-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKIN",
        "first_name": "SAMANTHA",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "GA",
            "license": "SLP003555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00677531A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.

Verify at the official NPI Registry.