Active NPI
Misty Dawn Smith
- Speech-Language Pathologist
- Jamestown, TN
National Provider Identifier
1992265805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4092
- Practice address
- 342 W Central Avenue
Jamestown, TN 38556 - Phone
- (931) 879-9073
- NPI assigned
- Mar 25, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 4092 | TN | Primary |
Addresses
Primary practice location
342 W Central Avenue
Jamestown, TN 38556
Mailing address
524 N Main St
Jamestown, TN 38556-3247
Phone (931) 267-8784
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220921000172 | TN | Practitioner - Qualified Speech Language Pathologist | 3476938804 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553472000000",
"number": "1992265805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "524 N MAIN ST",
"city": "JAMESTOWN",
"state": "TN",
"postal_code": "385563247",
"telephone_number": "931-267-8784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "342 W CENTRAL AVENUE",
"city": "JAMESTOWN",
"state": "TN",
"postal_code": "38556",
"telephone_number": "931-879-9073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "MISTY",
"middle_name": "DAWN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-25",
"last_updated": "2019-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TN",
"license": "4092",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamestown, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.