Beachside Speech Club

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

BEACHSIDE SPEECH CLUB

Practice address

114 Dixwood Ave
Edgewater, FL 32132-1604

Phone

(386) 320-6130

NPI assigned

Jan 24, 2023

Last updated

Jan 24, 2023By 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

Marissa O'Neil, M.S., CCC-SLPNPI 1548974439

Title

Speech Language Pathologist/Owner

Phone

(386) 457-9532

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Marissa O'Neil, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Edgewater, FL
  • NPI 1548974439
  NPD Authorized official

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

{
    "created_epoch": "1674518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674518400000",
    "number": "1336855303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 DIXWOOD AVE",
            "city": "EDGEWATER",
            "state": "FL",
            "postal_code": "321321604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 DIXWOOD AVE",
            "city": "EDGEWATER",
            "state": "FL",
            "postal_code": "321321604",
            "telephone_number": "386-320-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACHSIDE SPEECH CLUB",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-24",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A",
        "authorized_official_last_name": "O'NEIL",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST/OWNER",
        "authorized_official_telephone_number": "386-457-9532",
        "authorized_official_credential": "M.S., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Marie Baker
• Taylar N Baker
• Michael Dean Baldwin, PHARMD
• Grant Bradford Barker
• Jodie Barko-Abshire, MSW
• Samantha Bergoine, D.C.
• Jeffrey R Berner, PT
• Leslie R Betts
• Bhi of Central Florida Corporation (SafeNet Non-Emergency Transportation)
• Noah Benjamin Bigman, FNP-C

• Speech-Language Pathologist in Edgewater, FL
• Providers in Edgewater, 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 Jan 24, 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.