Individual provider Active NPI

Melissa Vincent, SLP

  • Speech-Language Pathologist
  • St Augustine, FL
National Provider Identifier
1417364498
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA14597 Issued in FL
Practice address
111 Nature Walk Pkwy Unit 108
St Augustine, FL 32092-3065
Phone
(904) 328-7489
Fax
(904) 490-8549
NPI assigned
Jul 22, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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 SA14597 FL Primary

Addresses

Primary practice location

111 Nature Walk Pkwy Unit 108
St Augustine, FL 32092-3065

Mailing address

111 Nature Walk Pkwy Unit 108
St Augustine, FL 32092-3065
Phone (904) 328-7489

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

State licenses

LicenseStateTypeSpecialty
SA14597FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Honey Pediatric Behavioral Health LLC CurrentSince Nov 9, 2025 Accepting new patients
Lively Speech and Language Therapy, LLC Speech-Language Pathologist CurrentSince Nov 9, 2025 Accepting new patients

Locations

111 Nature Walk Pkwy
Unit 108
St Augustine, FL 32092
Phone (904) 328-7489

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": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1417364498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 NATURE WALK PKWY UNIT 108",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923065",
            "telephone_number": "904-328-7489",
            "fax_number": "904-490-8549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 NATURE WALK PKWY UNIT 108",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923065",
            "telephone_number": "904-328-7489",
            "fax_number": "904-490-8549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "MELISSA",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA14597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2025; 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.