Individual provider Active NPI

Erin Elizabeth Ebert, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Orange City, FL
National Provider Identifier
1184178337
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA18567 Issued in FL
Practice address
2669 Enterprise Rd
Orange City, FL 32763-8217
Phone
(407) 530-5063
Fax
(877) 399-5578
NPI assigned
Aug 4, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2024

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 SA18567 FL Primary

Addresses

Primary practice location

2669 Enterprise Rd
Orange City, FL 32763-8217

Mailing address

736 W Florence Ave
Deland, FL 32720-3205
Phone (386) 748-4499

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SA18567FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speech Works Pediatric Therapy, LLC Speech-Language Assistant Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1470268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1184178337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 W FLORENCE AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203205",
            "telephone_number": "386-748-4499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2669 ENTERPRISE RD",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638217",
            "telephone_number": "407-530-5063",
            "fax_number": "877-399-5578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERT",
        "first_name": "ERIN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-04",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA18567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; 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.