Speech Avenues Therapy Co

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

SPEECH AVENUES THERAPY CO

Practice address

107 Longwood Ave
Rockledge, FL 32955-2827

Phone

(321) 338-2419

Fax

(321) 301-4278

NPI assigned

Sep 20, 2017

Last updated

Jul 20, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Gail Walter, M.S.CCC-SLPNPI 1720335052

Title

Ceo

Phone

(321) 338-2419

Specialties & licenses 7

Addresses

Other identifiers 1

Other names 1

• Speech Pathways of Brevard Inc Former legal business name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gail Lynn Walter, M.S., SLP-CCC

  • Speech-Language Pathologist
  • Cocoa, FL
  • NPI 1720335052
  Medicare reassignment Care Compare group NPD Authorized official
• Kailey Tara Watson, OTR/L

  • Occupational Therapist
  • Rockledge, FL
  • NPI 1760207724
  Medicare reassignment Care Compare group NPD
• Christopher M Whidden

  • Speech-Language Pathologist
  • Rockledge, FL
  • NPI 1174308860
  Medicare reassignment Care Compare group NPD
• Erica L Gallinat, SLP-CFY

  • Speech-Language Pathologist
  • Windsor, CT
  • NPI 1083979629

  FL

  Medicare reassignment Care Compare group NPD
• Jane B Kran, MS CCC-SLP

  • Speech-Language Pathologist
  • Orlando, FL
  • NPI 1598859068
  Medicare reassignment NPD
• Audrey Holly Carr, SLP-ASSISTANT

  • Speech-Language Assistant
  • Rockledge, FL
  • NPI 1326691031
  NPD

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1316456452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4555 SHOWDOW ST",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329262807",
            "telephone_number": "321-338-2419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 LONGWOOD AVE",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552827",
            "telephone_number": "321-338-2419",
            "fax_number": "321-301-4278"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1237 Florida Ave S",
            "address_purpose": "LOCATION",
            "city": "Rockledge",
            "state": "FL",
            "postal_code": "32955",
            "country_code": "US",
            "telephone_number": "321-338-2419",
            "fax_number": "321-284-8190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPEECH AVENUES THERAPY CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-20",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "WALTER",
        "authorized_official_first_name": "GAIL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "321-338-2419",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S.CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA12232",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006382800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Speech Pathways of Brevard Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Space Coast Health Foundation, Inc.
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• Stephanie Spahr
• Speech Garden of Brevard LLC
• Spine by Design Chiropractic LLC (Spine By Design Chiropractic)
• Spine2 LLC (Brevard Chiropractic & Injury Center)
• Marja J Sprock, M.D.
• Julia Diane St. Clair, MS, RMHCI

• Clinic/Center in Rockledge, FL
• Providers in Rockledge, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.