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TRACI A SMALLWOOD MA CCC SLP
NPI 1609099647
Speech-Language Pathologist in Plymouth, MN

Active since April 10, 2007
15600 36TH AVE N STE 120, PLYMOUTH, MN 55446(763) 595-0812(763) 595-0824 Get Directions Write a Review

NPPES record last updated: September 22, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Traci A Smallwood Ma Ccc Slp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRACI A SMALLWOOD MA CCC SLP (NPI 1609099647) is an individual speech-language pathologist provider in Plymouth, Minnesota, licensed in Minnesota (LICC-247) and active in the NPI registry since April 2007.

NPPES Registry Identity

NPI1609099647
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameTRACI A SMALLWOODCredential: MA CCC SLP
Location Address15600 36TH AVE N STE 120Plymouth, MN 55446-3687
Mailing Address15600 36th Ave N Ste 120Plymouth, MN 55446-3687 · (763) 595-0812 · Fax (763) 595-0824
Phone(763) 595-0812
Fax(763) 595-0824
Sole ProprietorNo
Enumeration DateApril 10, 2007
Last NPPES UpdateSeptember 22, 2025
NPPES CertifiedSeptember 22, 2025
✔ NPI 1609099647 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
License✔ Licensed in MN · LICC-247
Definition
The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.
15600 36TH AVE N STE 120, Plymouth, MN 55446
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Traci A Smallwood Ma Ccc Slp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Traci Smallwood reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Minnetonka Pediatric Therapy Center, LLC
Same address
Speech-Language Pathologist
15600 36TH AVE N STE 120
Plymouth, MN 55446
  • Reassigned Medicare billing, Minnesota enrollment
  • 8 clinicians in this Medicare group
NPI 1891998035 (763) 595-0812

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MEGAN STUMPF
Speech-Language Pathologist
15600 36TH AVE N STE 120
PLYMOUTH, MN 55446
Hennepin County (763) 595-0812
LINDSAY RENEE BARRETT MA/CCC-SLP
Speech-Language Pathologist
15600 36TH AVE N STE 120
PLYMOUTH, MN 55446
Hennepin County (763) 595-0812
ELIZABETH ELAINE MCGLYNN
Speech-Language Pathologist
15600 36TH AVE N STE 120
PLYMOUTH, MN 55446
Hennepin County (763) 595-0812
SARAH JOY MOEN PT, DPT
Physical Therapist (Pediatrics)
15600 36TH AVE N STE 120
PLYMOUTH, MN 55446
Hennepin County (763) 595-0812
ELIZABETH ASTURIAS MS OTR/L
Occupational Therapist (Pediatrics)
15600 36TH AVE N STE 120
PLYMOUTH, MN 55446
Hennepin County (763) 595-0812
KAYE M BAUMGARDNER MS CCC-SLP, COM, CLC
Speech-Language Pathologist
15600 36TH AVE N STE 120
PLYMOUTH, MN 55446
Hennepin County (763) 595-0812
BRITTANY WINTER
Occupational Therapist
15600 36TH AVE N STE 120
PLYMOUTH, MN 55446
Hennepin County (763) 595-0812
KATHERINE ELIZABETH LAMB MS CCC-SLP
Speech-Language Pathologist
15600 36TH AVE N STE 120
PLYMOUTH, MN 55446
Hennepin County (635) 950-8127

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Traci Smallwood's NPI number?

The NPI number for Traci Smallwood is 1609099647. It was assigned to this individual provider in the NPPES registry on April 10, 2007.

Where is Traci Smallwood located?

Traci Smallwood practices at 15600 36th Ave N Ste 120, Plymouth, MN 55446. The listed phone number is (763) 595-0812.

What is Traci Smallwood's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Traci Smallwood enrolled in Medicare?

Yes. Traci Smallwood is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Traci Smallwood's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Traci Smallwood reassigns Medicare benefits to Minnetonka Pediatric Therapy Center, LLC (Plymouth, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Traci Smallwood's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Traci Smallwood accept?

Health plans from Medica list Traci Smallwood as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Traci Smallwood was last updated on September 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.