Individual provider Active NPI

Laine Samantha Hemminger Fisher-Gayle, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Atlantic, IA
National Provider Identifier
1861832511
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
015194 Issued in OR
Practice address
1501 E 10TH St
Atlantic, IA 50022-1936
Phone
(712) 243-3250
NPI assigned
Jun 26, 2013
Last updated
Dec 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 002146 IA
Speech-Language Pathologist 235Z00000X 015194 OR Primary

Addresses

Primary practice location

1501 E 10TH St
Atlantic, IA 50022-1936

Mailing address

1475 Capitol St NE
Salem, OR 97301-7850
Phone (971) 599-1712

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210114002044 OR Practitioner - Qualified Speech Language Pathologist 7810300720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sensible Speech-Language Pathology, IncGroup PAC ID 7012279433, 4 clinicians

Practice addresses (Care Compare)

1475 Capitol St NE
Salem, OR 97301-7850
Phone (971) 599-1712

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
015194ORMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sensible Speech-Language Pathology, Inc Speech-Language Pathologist CurrentSince Dec 29, 2020 Accepting new patients

Locations

1475 Capitol St NE
Salem, OR 97301
Phone (971) 559-1712

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, 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": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1861832511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 CAPITOL ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973017850",
            "telephone_number": "971-599-1712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 E 10TH ST",
            "city": "ATLANTIC",
            "state": "IA",
            "postal_code": "500221936",
            "telephone_number": "712-243-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER-GAYLE",
        "first_name": "LAINE",
        "middle_name": "SAMANTHA HEMMINGER",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-26",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IA",
            "license": "002146",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "015194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantic, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; 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.