Online Spech Therapy P.C.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

ONLINE SPECH THERAPY P.C.

Practice address

1330 Connecticut St
Imperial Beach, CA 91932-3224

Phone

(417) 438-8931

NPI assigned

Dec 20, 2023

Organization subpart

No

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

Authorized official

Name

Madison Blaylock, SLPNPI 1184211708

Title

President

Phone

(417) 438-8931

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Madison Blaylock

  • Speech-Language Pathologist
  • San Diego, CA
  • NPI 1184211708
  NPD Authorized official

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

{
    "created_epoch": "1703030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703030400000",
    "number": "1093584914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 CONNECTICUT ST",
            "city": "IMPERIAL BEACH",
            "state": "CA",
            "postal_code": "919323224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 CONNECTICUT ST",
            "city": "IMPERIAL BEACH",
            "state": "CA",
            "postal_code": "919323224",
            "telephone_number": "417-438-8931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONLINE SPECH THERAPY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-20",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A",
        "authorized_official_last_name": "BLAYLOCK",
        "authorized_official_first_name": "MADISON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "417-438-8931",
        "authorized_official_credential": "SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Novencido, PT, DPT
• Viana Nunez
• Shane S O'Brien, DEEP SEA DIVING IDC
• Jason Oh, PHARM.D.
• Leanna Marie Olivas
• Leonor A Ordonez, MD
• Maria Osborn
• Oscar a Bracamontes DDS
• Alfonso Osuna
• Alma Guadalupe Paredes, SUD

• Speech-Language Pathologist in Imperial Beach, CA
• Providers in Imperial Beach, CA by specialty
• Speech-Language Pathologist in California

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