Active NPI
Amber Dawn Valentine, MS, CCC-SLP, BCS-S,
- Speech-Language Pathologist
- Jacksonville, FL
National Provider Identifier
1063824001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA 12928
- Practice address
- 4500 San Pablo Rd S
Jacksonville, FL 32224-1865 - Phone
- (859) 358-6864
- NPI assigned
- May 26, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA 12928 | FL | Primary |
| Speech-Language Pathologist | 235Z00000X | KY 3283 | KY |
Addresses
Primary practice location
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Mailing address
1761 Fiddlers Ridge Dr
Fleming Island, FL 32003-7241
Phone (859) 358-6864
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA 12928 | FL | MD | Speech-Language Pathologist |
| KY 3283 | KY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420243200000",
"number": "1063824001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1761 FIDDLERS RIDGE DR",
"city": "FLEMING ISLAND",
"state": "FL",
"postal_code": "320037241",
"telephone_number": "859-358-6864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 SAN PABLO RD S",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322241865",
"telephone_number": "859-358-6864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALENTINE",
"first_name": "AMBER",
"middle_name": "DAWN",
"credential": "MS, CCC-SLP, BCS-S,",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-26",
"last_updated": "2015-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA 12928",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "KY",
"license": "KY 3283",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.