Individual provider Active NPI

Evelyn M Falcon, MS, CCC-SLP

  • Speech-Language Pathologist
  • Miami Lakes, FL
National Provider Identifier
1386714368
Registry record updated Apr 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP0005134 Issued in GA
Practice address
6625 Miami Lakes Dr E
Suite 383
Miami Lakes, FL 33014-2708
Phone
(305) 498-1306
Fax
(305) 726-0093
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 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 SLP0005134 GA Primary

Addresses

Primary practice location

6625 Miami Lakes Dr E
Suite 383
Miami Lakes, FL 33014-2708

Mailing address

14602 Rosewood Rd
Miami Lakes, FL 33014-2658
Phone (305) 498-1306

Other identifiers 5

IdentifierTypeStateIssuer
000925647AOtherGAPEACHSTATE
326070OtherGAWELLCARE
002243700MedicaidFL
10034878OtherGAAMERIGROUP
000925647AMedicaidGA

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
SLP0005134GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Falcon Physical Therapy, Inc. Past Accepting new patients
Use Your Words Pediatric Speech Therapy, Inc Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 2

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397001600000",
    "number": "1386714368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14602 ROSEWOOD RD",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142658",
            "telephone_number": "305-498-1306",
            "fax_number": "305-726-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6625 MIAMI LAKES DR E",
            "address_2": "SUITE 383",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142708",
            "telephone_number": "305-498-1306",
            "fax_number": "305-726-0093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALCON",
        "first_name": "EVELYN",
        "middle_name": "M",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2014-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP0005134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEACHSTATE",
            "identifier": "000925647A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "326070",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002243700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10034878",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000925647A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.