Individual provider Active NPI

Megan Bennett

  • Speech-Language Pathologist
  • Port Orange, FL
National Provider Identifier
1346736386
Registry record updated Jul 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
131173 Issued in AK
Practice address
5535 S Williamson Blvd Ste 774
Port Orange, FL 32128-8321
Phone
(888) 265-2680
Fax
(386) 944-7202
NPI assigned
Jul 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2018

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 131173 AK Primary

Addresses

Primary practice location

5535 S Williamson Blvd Ste 774
Port Orange, FL 32128-8321

Mailing address

5535 S Williamson Blvd Ste 774
Port Orange, FL 32128-8321
Phone (888) 265-2680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230531000704 AK Practitioner - Qualified Speech Language Pathologist 5496003238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harmony Speech and Language Therapy LLCGroup PAC ID 1254747124, 2 clinicians

Practice addresses (Care Compare)

4038 Yvonne Ave
Fairbanks, AK 99709-3503

4038 Yvonne Ave
Fairbanks, AK 99709-3568
Phone (907) 687-6700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
131173AKMDSpeech-Language Pathologist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530489600000",
    "number": "1346736386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5535 S WILLIAMSON BLVD STE 774",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321288321",
            "telephone_number": "888-265-2680",
            "fax_number": "386-944-7202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 S WILLIAMSON BLVD STE 774",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321288321",
            "telephone_number": "888-265-2680",
            "fax_number": "386-944-7202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "MEGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2018-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AK",
            "license": "131173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.