Active NPI
Chris Durnin, MACCC-SLP
- Speech-Language Pathologist
- Mount Dora, FL
National Provider Identifier
1083714521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA6753
- Practice address
- 3460 Laurel Dr
Mount Dora, FL 32757-4604 - Phone
- (352) 385-4764
- NPI assigned
- Sep 24, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA6753 | FL | Primary |
Addresses
Primary practice location
3460 Laurel Dr
Mount Dora, FL 32757-4604
Mailing address
3460 Laurel Dr
Mount Dora, FL 32757-4604
Phone (352) 385-4764
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 889618600 | Medicaid | FL |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083714521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3460 LAUREL DR",
"city": "MOUNT DORA",
"state": "FL",
"postal_code": "327574604",
"telephone_number": "352-385-4764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3460 LAUREL DR",
"city": "MOUNT DORA",
"state": "FL",
"postal_code": "327574604",
"telephone_number": "352-385-4764"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DURNIN",
"first_name": "CHRIS",
"credential": "MACCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA6753",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "889618600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mount Dora, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.