Mackenzie Jordan Robertson, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA21430 Issued in FL

Practice address

1569 SW 45TH Rd
Gainesville, FL 32608-9126

Phone

(304) 617-2040

NPI assigned

Feb 20, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Teamup Therapy LLC

  • Speech-Language Pathologist
  • Valdosta, GA
  • NPI 1588358642
  NPD (past)

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

{
    "created_epoch": "1740009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1013713163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1569 SW 45TH RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326089126",
            "telephone_number": "304-617-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1569 SW 45TH RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326089126",
            "telephone_number": "304-617-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "MACKENZIE",
        "middle_name": "JORDAN",
        "name_prefix": "Ms.",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-20",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IA",
            "license": "129941",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "18429",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA21430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassie Lord Robertson, DNP, APRN-BC
• Elyse Robertson, LMT
• Falicia Sharmaine Robertson, M.D.
• Larah Ellen Robertson
• Loic D Robertson
• Jennifer N Robeson, OPA-C
• Steven A Robicsek, MD, PHD
• Steven Kenneth Robidoux, RN
• Albert R Robinson, MD
• Alvieta Robinson

• Speech-Language Pathologist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.