Individual provider Active NPI

Jewel Deleveaux, SLPA

  • Speech-Language Assistant
  • Lakeland, FL
National Provider Identifier
1245004977
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SAH-2023-0051 Issued in NM
Practice address
6464 Sedgeford Dr
Lakeland, FL 33811-1833
Phone
(689) 209-4907
NPI assigned
Nov 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 0312 NH
Speech-Language Assistant 2355S0801X SI6376 FL
Speech-Language Assistant 2355S0801X SAH-2023-0051 NM Primary

Addresses

Primary practice location

6464 Sedgeford Dr
Lakeland, FL 33811-1833

Mailing address

6464 Sedgeford Dr
Lakeland, FL 33811-1833
Phone (689) 209-4907

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
0312NHMDOccupational Therapy Assistant
SI6376FLMDSpeech-Language Assistant
SAH-2023-0051NMMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1699833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1245004977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6464 SEDGEFORD DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338111833",
            "telephone_number": "689-209-4907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6464 SEDGEFORD DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338111833",
            "telephone_number": "689-209-4907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELEVEAUX",
        "first_name": "JEWEL",
        "credential": "SLPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-13",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "NH",
            "license": "0312",
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "FL",
            "license": "SI6376",
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "NM",
            "license": "SAH-2023-0051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.