Ann-Marie Gordon Butler, M.A., CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA7630 Issued in FL

Practice address

1 Pacific Dr
Palm Coast, FL 32164-7534

Phone

(904) 444-5300

Fax

(904) 615-8285

NPI assigned

Apr 17, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Let's Go Speech LLC

  • Speech-Language Pathologist
  • Palm Coast, FL
  • NPI 1184388852

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1386860708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PACIFIC DR",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321647534",
            "telephone_number": "904-444-5300",
            "fax_number": "904-615-8285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PACIFIC DR",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321647534",
            "telephone_number": "904-444-5300",
            "fax_number": "904-615-8285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON BUTLER",
        "first_name": "ANN-MARIE",
        "credential": "M.A., CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA7630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386860708",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melchor Gonzalez, M.D.
• Good Sam's Assisted Living Residence, LLC
• Good Samaritan Care Center Alf Inc
• Joanne Goodin
• Julie A Goodwin, MS
• Taylor Gordon
• Brian Stephen Gorski, PTA
• Heather Gould, COTA
• Michelle Gould
• Grace Behavioral Services, LLC

• Speech-Language Pathologist in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.