NPIMap

Organization Active NPI

Jacksonville's Children's Speech Center, Inc.

  • Speech-Language Pathologist
  • Neptune Beach, FL
National Provider Identifier
1417180761
Registry record updated Sep 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA9206 Issued in FL
Legal business name
JACKSONVILLE'S CHILDREN'S SPEECH CENTER, INC.
Practice address
1415 Atlantic Blvd
Suite B
Neptune Beach, FL 32266-1715
Phone
(904) 235-3444
Fax
(904) 396-7403
NPI assigned
Sep 2, 2009
Last updated
Sep 2, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2009

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

Authorized official

Name
Samantha K Droogsma, MS CCC-SLPNPI 1437230885
Title
Owner
Phone
(904) 235-3444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA9206 FL Primary

Addresses

Primary practice location

1415 Atlantic Blvd
Suite B
Neptune Beach, FL 32266-1715

Mailing address

1415 Atlantic Blvd
Suite B
Neptune Beach, FL 32266-1715
Phone (904) 235-3444

Other identifiers 1

IdentifierTypeStateIssuer
8913340MedicaidFL

National Provider Directory

National Provider Directory

Locations

1415 Atlantic Blvd
Ste B
Neptune Beach, FL 32266
Phone (904) 235-3444

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1251849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251849600000",
    "number": "1417180761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 ATLANTIC BLVD",
            "address_2": "SUITE B",
            "city": "NEPTUNE BEACH",
            "state": "FL",
            "postal_code": "322661715",
            "telephone_number": "904-235-3444",
            "fax_number": "904-396-7403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 ATLANTIC BLVD",
            "address_2": "SUITE B",
            "city": "NEPTUNE BEACH",
            "state": "FL",
            "postal_code": "322661715",
            "telephone_number": "904-235-3444",
            "fax_number": "904-396-7403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE'S CHILDREN'S SPEECH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-02",
        "last_updated": "2009-09-02",
        "status": "A",
        "authorized_official_last_name": "DROOGSMA",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-235-3444",
        "authorized_official_credential": "MS CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA9206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8913340",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Neptune Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2009; 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.