Individual provider Active NPI

Jennifer Michele Belen, CCC-SLP

  • Speech-Language Pathologist
  • Palm Bay, FL
National Provider Identifier
1063142297
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA20499 Issued in FL
Practice address
911 Remington Green Dr SE
Palm Bay, FL 32909-6909
Phone
(862) 202-1408
NPI assigned
Jun 11, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 41YS00739500 NJ
Speech-Language Pathologist 235Z00000X SA20499 FL Primary

Addresses

Primary practice location

911 Remington Green Dr SE
Palm Bay, FL 32909-6909

Mailing address

911 Remington Green Dr SE
Palm Bay, FL 32909-6909
Phone (862) 202-1408

Other names 1

  • Jennifer Michele Patino Former name

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
SA20499FLMDSpeech-Language Pathologist
41YS00739500NJMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1654905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1063142297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 REMINGTON GREEN DR SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329096909",
            "telephone_number": "862-202-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 REMINGTON GREEN DR SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329096909",
            "telephone_number": "862-202-1408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELEN",
        "first_name": "JENNIFER",
        "middle_name": "MICHELE",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-11",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00739500",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA20499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "PATINO",
            "middle_name": "MICHELE",
            "credential": "MAIDEN NAME",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; 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.