Individual provider Active NPI

Kerantha Poole-Christian, MA, SLP

  • Speech-Language Pathologist
  • Hollywood, FL
National Provider Identifier
1114149994
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA8315 Issued in FL
Practice address
1721 N 54TH Ave
Hollywood, FL 33021-3925
Phone
(954) 968-9760
NPI assigned
May 3, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA8315 FL Primary

Addresses

Primary practice location

1721 N 54TH Ave
Hollywood, FL 33021-3925

Mailing address

1721 N 54TH Ave
Hollywood, FL 33021-3925

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241009001236 FL Practitioner - Qualified Speech Language Pathologist 6608307038 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ap Therapy LLCGroup PAC ID 9032552559, 56 clinicians

Practice addresses (Care Compare)

10790 Old Saint Augustine Rd
Jacksonville, FL 32257-1078
Phone (800) 380-9153

1248 Kingsley Ave
Orange Park, FL 32073-4699
Phone (800) 380-9153

1297 US Hwy 27 N
Lake Placid, FL 33852-7907
Phone (800) 380-9153

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SA8315FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ap Therapy LLC Speech-Language Pathologist CurrentSince Oct 13, 2025 Accepting new patients
Ap Therapy LLC Speech-Language Pathologist CurrentSince Oct 13, 2025 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Aug 27, 2024 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Aug 27, 2024 Accepting new patients

Locations

4870 Belfort Rd
Jacksonville, FL 32256
Phone (904) 332-0774

1297 US Highway 27 N
Lake Placid, FL 33852
Phone (407) 276-5023

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114149994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 N 54TH AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 N 54TH AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213925",
            "telephone_number": "954-968-9760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLE-CHRISTIAN",
        "first_name": "KERANTHA",
        "credential": "MA, SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA8315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.