Individual provider Active NPI

Robin Wray, MS

  • Speech-Language Pathologist
  • Fort Walton Beach, FL
National Provider Identifier
1194235648
Registry record updated Oct 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
15784 Issued in FL
Practice address
930 Mar Walt Dr D
Fort Walton Beach, FL 32547
Phone
(850) 226-8279
NPI assigned
Oct 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2017

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 15784 FL Primary

Addresses

Primary practice location

930 Mar Walt Dr D
Fort Walton Beach, FL 32547

Mailing address

3841 Indian TRL
Destin, FL 32541-2005
Phone (580) 301-2664

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
15784FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507593600000",
    "number": "1194235648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 INDIAN TRL",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325412005",
            "telephone_number": "580-301-2664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 MAR WALT DR D",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "32547",
            "telephone_number": "850-226-8279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRAY",
        "first_name": "ROBIN",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-10",
        "last_updated": "2017-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "15784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2017; 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.