Marissa Winburn

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA14578 Issued in FL

Practice address

636 Meadow Lake Dr
Freeport, FL 32439-2359

Phone

(850) 499-6052

NPI assigned

Jun 17, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Treehouse Therapies, LLC

  • Pediatric Physical Therapist
  • Fort Walton Beach, FL
  • NPI 1083380828

  Speech-Language Pathologist

  NPD (past)
• Treehouse Therapies, LLC

  • Speech-Language Pathologist
  • Fort Walton Beach, FL
  • NPI 1972800639
  NPD (past)

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1376924159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 MEADOW LAKE DR",
            "city": "FREEPORT",
            "state": "FL",
            "postal_code": "324392359",
            "telephone_number": "850-499-6052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 MEADOW LAKE DR",
            "city": "FREEPORT",
            "state": "FL",
            "postal_code": "324392359",
            "telephone_number": "850-499-6052"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4100 S Ferdon Blvd",
            "address_purpose": "LOCATION",
            "city": "Crestview",
            "state": "FL",
            "postal_code": "325365252",
            "country_code": "US",
            "telephone_number": "850-499-6052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINBURN",
        "first_name": "MARISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-17",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ7095",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA14578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Ray Weeks, R PH
• Hillary Wheeler
• Sandra Baker White, APRN
• Kelly Erin Williams
• Chassity Ann Wilson, APRN
• Lana Winjum, DC
• Lauren Neighbors Youtz, PA-C

• All providers in Freeport, FL
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.