NPIMap

Organization Active NPI

Yakety Yak Speech-Language Pathologists, Inc.

  • Speech-Language Pathologist
  • Kissimmee, FL
National Provider Identifier
1376867465
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
YAKETY YAK SPEECH-LANGUAGE PATHOLOGISTS, INC.
Practice address
1107 Mabbette St
Kissimmee, FL 34741-5161
Phone
(407) 201-8079
Fax
(407) 343-9180
NPI assigned
Mar 18, 2010
Last updated
Oct 17, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Authorized official

Name
Ms. Jennifer Autenrieth, M.A. CCC-SLPNPI 1164565214
Title
Speech Pathologist, President
Phone
(407) 201-8079

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X FL
Physical Therapist 225100000X FL
Occupational Therapist 225X00000X FL
Speech-Language Assistant 2355S0801X FL
Speech-Language Pathologist 235Z00000X FL Primary

Addresses

Primary practice location

1107 Mabbette St
Kissimmee, FL 34741-5161

Mailing address

1107 Mabbette St
Kissimmee, FL 34741-5161
Phone (407) 201-8079

Other identifiers 1

IdentifierTypeStateIssuer
890635100MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Yakety Yak Speech Language Pathologists2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1107 Mabbette St
Kissimmee, FL 34741
Phone (407) 201-8079

Practitioners & affiliated clinicians

Practitioners 65

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.

View all 65

NPI Registry JSON

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

{
    "created_epoch": "1268870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476662400000",
    "number": "1376867465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 MABBETTE ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415161",
            "telephone_number": "407-201-8079",
            "fax_number": "407-343-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 MABBETTE ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415161",
            "telephone_number": "407-201-8079",
            "fax_number": "407-343-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAKETY YAK SPEECH-LANGUAGE PATHOLOGISTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-18",
        "last_updated": "2016-10-17",
        "status": "A",
        "authorized_official_last_name": "AUTENRIETH",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "SPEECH PATHOLOGIST, PRESIDENT",
        "authorized_official_telephone_number": "407-201-8079",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.A. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890635100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.