Kristen Moore Forgue, MS CCCSLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA6273 Issued in FL

Practice address

710 E Bella Vista St
Lakeland, FL 33805

Phone

(863) 686-3189

Fax

(863) 682-1348

NPI assigned

Jul 10, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275567174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 E BELLA VISTA ST",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33805",
            "telephone_number": "863-686-3189",
            "fax_number": "863-682-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 E BELLA VISTA ST",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33805",
            "telephone_number": "863-686-3189",
            "fax_number": "863-682-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORGUE",
        "first_name": "KRISTEN",
        "middle_name": "MOORE",
        "name_prefix": "Mrs.",
        "credential": "MS CCCSLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA6273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATA",
            "identifier": "244",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "S2868",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "114969",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CITRUS HEALTHCARE",
            "identifier": "11982301",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Denise Ford Joseph, DC
• Chloe Ford, NP
• Rachel Magdalene Ford, RBT
• Tracie M Ford, LCSW
• Matthew Joseph Forestiere, M.D.
• Damaris Yamilet Fornaris Garcell
• Amy J Fort, ARNP
• Dominick Richard Fortunato, BEHAVIOR TECHNICIAN
• Carlos Enrique Fossi, M,D.
• Kiasia Lashae Foster

• Speech-Language Pathologist in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.