Active NPI
Jasmine Smith
- Speech-Language Assistant
- Eagle Lake, FL
National Provider Identifier
1114719481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- SI6993
- Practice address
- 405 S Tangerine CT
Eagle Lake, FL 33839-3510 - Phone
- (863) 589-3007
- NPI assigned
- May 21, 2025
- Last updated
- May 21, 2025
- Sex
- Unspecified or another gender identity
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | |||
| Speech-Language Pathologist | 235Z00000X | |||
| Speech-Language Assistant | 2355S0801X | SI6993 | FL | Primary |
Addresses
Primary practice location
405 S Tangerine CT
Eagle Lake, FL 33839-3510
Mailing address
405 S Tangerine CT
Eagle Lake, FL 33839-3510
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
| License | State | Type | Specialty |
|---|---|---|---|
| SI6993 | FL | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747785600000",
"number": "1114719481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 S TANGERINE CT",
"city": "EAGLE LAKE",
"state": "FL",
"postal_code": "338393510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 S TANGERINE CT",
"city": "EAGLE LAKE",
"state": "FL",
"postal_code": "338393510",
"telephone_number": "863-589-3007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "JASMINE",
"sole_proprietor": "YES",
"sex": "X",
"enumeration_date": "2025-05-21",
"last_updated": "2025-05-21",
"certification_date": "2025-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "FL",
"license": "SI6993",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eagle Lake, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.