Individual provider Active NPI

Jacqueline Kaylor

  • Speech-Language Assistant
  • Port St Lucie, FL
National Provider Identifier
1033658745
Registry record updated Dec 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SI2435 Issued in FL
Practice address
549 NW Lake Whitney PL
Suite 103
Port St Lucie, FL 34986-1606
Phone
(772) 301-1207
NPI assigned
Feb 14, 2017
Last updated
Dec 4, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SI2435 FL Primary

Addresses

Primary practice location

549 NW Lake Whitney PL
Suite 103
Port St Lucie, FL 34986-1606

Mailing address

549 NW Lake Whitney PL
Suite 103
Port St Lucie, FL 34986-1606
Phone (772) 301-1207

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
SI2435FLMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1033658745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "549 NW LAKE WHITNEY PL",
            "address_2": "SUITE 103",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861606",
            "telephone_number": "772-301-1207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "549 NW LAKE WHITNEY PL",
            "address_2": "SUITE 103",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861606",
            "telephone_number": "772-301-1207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAYLOR",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-14",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "FL",
            "license": "SI2435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; 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.