Active NPI
Libby Jasmine King, M.A., CCC-SLP
- Speech-Language Pathologist
- Melbourne, FL
National Provider Identifier
1003314139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA17060
- Practice address
- 6550 N Wickham Rd Ste 8
Melbourne, FL 32940-2038 - Phone
- (321) 427-7373
- NPI assigned
- Jan 23, 2018
- 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 | SA17060 | FL | Primary |
Addresses
Primary practice location
6550 N Wickham Rd Ste 8
Melbourne, FL 32940-2038
Mailing address
465 Newfound Harbor Dr
Merritt Island, FL 32952-2655
Phone (321) 427-7373
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 023749900 | Medicaid | FL |
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 |
|---|---|---|---|
| SA17060 | FL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Speech Innovations of Central Florida LLC | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Speech-Language Pathologist
- Melbourne, FL
- NPI 1982268173
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568332800000",
"number": "1003314139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "465 NEWFOUND HARBOR DR",
"city": "MERRITT ISLAND",
"state": "FL",
"postal_code": "329522655",
"telephone_number": "321-427-7373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6550 N WICKHAM RD STE 8",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329402038",
"telephone_number": "321-427-7373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "LIBBY",
"middle_name": "JASMINE",
"credential": "M.A., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-23",
"last_updated": "2019-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA17060",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "023749900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.