Individual provider Active NPI

Jessica Garretson

  • Speech-Language Assistant
  • Oviedo, FL
National Provider Identifier
1205209871
Registry record updated Nov 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SI2477 Issued in FL
Practice address
1000 W Broadway St
Suite #214
Oviedo, FL 32765-9260
Phone
(407) 359-5693
Fax
(407) 792-5693
NPI assigned
Nov 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SI2477 FL Primary

Addresses

Primary practice location

1000 W Broadway St
Suite #214
Oviedo, FL 32765-9260

Mailing address

1725 Belmont Ave
Eustis, FL 32726-7379
Phone (352) 430-8260

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

LicenseStateTypeSpecialty
SI2477FLMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446595200000",
    "number": "1205209871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 BELMONT AVE",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327267379",
            "telephone_number": "352-430-8260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W BROADWAY ST",
            "address_2": "SUITE #214",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327659260",
            "telephone_number": "407-359-5693",
            "fax_number": "407-792-5693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETSON",
        "first_name": "JESSICA",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-04",
        "last_updated": "2015-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "FL",
            "license": "SI2477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2015; 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.