Individual provider Active NPI

Cynthia Irish, SLP

  • Speech-Language Pathologist
  • Jensen Beach, FL
National Provider Identifier
1265645147
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 4620 Issued in FL
Practice address
3496 NW Federal Hwy Ste G
Jensen Beach, FL 34957-4441
Phone
(772) 223-5677
Fax
(772) 223-4997
NPI assigned
May 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 SA 4620 FL Primary

Addresses

Primary practice location

3496 NW Federal Hwy Ste G
Jensen Beach, FL 34957-4441

Mailing address

6828 NW Granger Ave
Port Saint Lucie, FL 34983-1305
Phone (772) 215-0255

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
SA 4620FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1265645147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6828 NW GRANGER AVE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349831305",
            "telephone_number": "772-215-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3496 NW FEDERAL HWY STE G",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349574441",
            "telephone_number": "772-223-5677",
            "fax_number": "772-223-4997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRISH",
        "first_name": "CYNTHIA",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 4620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jensen Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.