Active NPI
Kayla Ann Sampson, M.A. CCC-SLP
- Speech-Language Pathologist
- Jacksonville, NC
National Provider Identifier
1932550712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 12800
- Practice address
- 410 New Bridge St
Jacksonville, NC 28540-4739 - Phone
- (850) 994-3456
- NPI assigned
- Jun 23, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 113566 | TX | |
| Speech-Language Pathologist | 235Z00000X | SZ7608 | FL | |
| Speech-Language Pathologist | 235Z00000X | 12800 | NC | Primary |
Addresses
Primary practice location
410 New Bridge St
Jacksonville, NC 28540-4739
Mailing address
160 Twining Rose LN
Holly Ridge, NC 28445
Phone (501) 912-1480
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12800 | NC | MD | General Practice Dentistry |
| SZ7608 | FL | MD | Speech-Language Pathologist |
| 113566 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519171200000",
"number": "1932550712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 TWINING ROSE LN",
"city": "HOLLY RIDGE",
"state": "NC",
"postal_code": "28445",
"telephone_number": "501-912-1480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 NEW BRIDGE ST",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285404739",
"telephone_number": "850-994-3456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMPSON",
"first_name": "KAYLA",
"middle_name": "ANN",
"credential": "M.A. CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-23",
"last_updated": "2018-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "113566",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SZ7608",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "12800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.