Individual provider Active NPI

Samantha Marion Lovegreen, MS, CCC-SLP

  • Speech-Language Pathologist
  • Peabody, MA
National Provider Identifier
1912477175
Registry record updated Nov 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
76962-SP-SL Issued in MA
Practice address
1R Newbury St Ste 104
Peabody, MA 01960-3816
Phone
(978) 535-3355
Fax
(978) 535-4655
NPI assigned
Nov 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2018

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 76962-SP-SL MA Primary

Addresses

Primary practice location

1R Newbury St Ste 104
Peabody, MA 01960-3816

Mailing address

1R Newbury St Ste 104
Peabody, MA 01960-3816
Phone (978) 535-3355

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 Science

State licenses

LicenseStateTypeSpecialty
76962-SP-SLMAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1543536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543536000000",
    "number": "1912477175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1R NEWBURY ST STE 104",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019603816",
            "telephone_number": "978-535-3355",
            "fax_number": "978-535-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1R NEWBURY ST STE 104",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019603816",
            "telephone_number": "978-535-3355",
            "fax_number": "978-535-4655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVEGREEN",
        "first_name": "SAMANTHA",
        "middle_name": "MARION",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-30",
        "last_updated": "2018-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "76962-SP-SL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; 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.