Individual provider Active NPI

Stephanie Mayerson

  • Speech-Language Pathologist
  • Orlando, FL
National Provider Identifier
1013625664
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA22538 Issued in FL
Practice address
1239 Mount Vernon St
Orlando, FL 32803-5417
Phone
(407) 810-2773
Fax
(407) 867-6203
NPI assigned
Nov 14, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X SA22538 FL Primary

Addresses

Primary practice location

1239 Mount Vernon St
Orlando, FL 32803-5417

Mailing address

1239 Mount Vernon St
Orlando, FL 32803-5417
Phone (407) 810-2773

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

State licenses

LicenseStateTypeSpecialty
SA22538FLMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1013625664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1239 MOUNT VERNON ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328035417",
            "telephone_number": "407-810-2773",
            "fax_number": "407-867-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1239 MOUNT VERNON ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328035417",
            "telephone_number": "407-810-2773",
            "fax_number": "407-867-6203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYERSON",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-14",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA22538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.