Active NPI
Collins Blake Scott
- Speech-Language Pathologist
- Orlando, FL
National Provider Identifier
1194270504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA14574
- Practice address
- 1733 Lakemont Ave
# 106
Orlando, FL 32814-6350 - Phone
- (502) 316-1018
- NPI assigned
- Aug 16, 2016
- Reactivated
- Feb 12, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA14574 | FL | Primary |
Addresses
Primary practice location
1733 Lakemont Ave
# 106
Orlando, FL 32814-6350
Mailing address
1733 Lakemont Ave
# 106
Orlando, FL 32814-6350
Phone (502) 316-1018
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA14574 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739318400000",
"number": "1194270504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1733 LAKEMONT AVE",
"address_2": "# 106",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328146350",
"telephone_number": "502-316-1018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1733 LAKEMONT AVE",
"address_2": "# 106",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328146350",
"telephone_number": "502-316-1018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOTT",
"first_name": "COLLINS",
"middle_name": "BLAKE",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-08-16",
"last_updated": "2025-02-12",
"deactivation_date": "2024-10-16",
"reactivation_date": "2025-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA14574",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.