Physician Compare National (NPI:1831290576)

HEALTHCARE PROVIDER: BONNIE SMITH PHD, CCC-SLP

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1831290576
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4587717723
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090805000311
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SMITH
	Individual professional last name
Provider First Name	BONNIE
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1981
	Individual professional's medical school graduation year
Primary Specialty	QUALIFIED SPEECH LANGUAGE PATHOLOGIST
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	4122 LIBRARY ST
	Group Practice or individual's line 1 address
City	PORT CHARLOTTE
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	339482275
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y