Active NPI
Bernelda Janessa Thomas, M.S CCC-SLP
- Speech-Language Pathologist
- Boca Raton, FL
National Provider Identifier
1356773253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4834
- Practice address
- 2840 NW 2ND Avenue
Suite 104
Boca Raton, FL 33431 - Phone
- (561) 989-8595
- Fax
- (561) 989-8476
- NPI assigned
- Aug 1, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 4834 | TN | Primary |
Addresses
Primary practice location
2840 NW 2ND Avenue
Suite 104
Boca Raton, FL 33431
Mailing address
2840 NW 2ND Avenue
Suite 104
Boca Raton, FL 33431
Phone (561) 989-8595
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4834 | Other | TN | TN BOARD OF HEALTH |
| 14038466 | Other | TN | ASHA |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4834 | TN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375315200000",
"number": "1356773253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2840 NW 2ND AVENUE",
"address_2": "SUITE 104",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "33431",
"telephone_number": "561-989-8595",
"fax_number": "561-989-8476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2840 NW 2ND AVENUE",
"address_2": "SUITE 104",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "33431",
"telephone_number": "561-989-8595",
"fax_number": "561-989-8476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "BERNELDA",
"middle_name": "JANESSA",
"name_prefix": "Miss",
"credential": "M.S CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-01",
"last_updated": "2013-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TN",
"license": "4834",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TN BOARD OF HEALTH",
"identifier": "4834",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASHA",
"identifier": "14038466",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boca Raton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.