Individual provider Active NPI

Jennifer Rickel, M.S.

  • Speech-Language Pathologist
  • Davie, FL
National Provider Identifier
1366866709
Registry record updated Feb 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SZ6576 Issued in FL
Practice address
12545 Orange Dr Ste 502
Davie, FL 33330-4306
Phone
(954) 474-8048
NPI assigned
Feb 5, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2014

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 SZ6576 FL Primary

Addresses

Primary practice location

12545 Orange Dr Ste 502
Davie, FL 33330-4306

Mailing address

511 SE 5TH Ave Apt 711
Fort Lauderdale, FL 33301-2968
Phone (561) 322-9235

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

LicenseStateTypeSpecialty
SZ6576FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1391558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391558400000",
    "number": "1366866709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 SE 5TH AVE APT 711",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012968",
            "telephone_number": "561-322-9235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12545 ORANGE DR STE 502",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333304306",
            "telephone_number": "954-474-8048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKEL",
        "first_name": "JENNIFER",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-05",
        "last_updated": "2014-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ6576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; 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.