Individual provider Active NPI

Jennifer Nicole Eckardt

  • Speech-Language Pathologist
  • Miami, FL
National Provider Identifier
1417430422
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA17394 Issued in FL
Practice address
12030 SW 129TH CT Ste 209
Miami, FL 33186-4584
Phone
(786) 429-3619
NPI assigned
Sep 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA17394 FL Primary
Speech-Language Pathologist 235Z00000X SZ8829 FL

Addresses

Primary practice location

12030 SW 129TH CT Ste 209
Miami, FL 33186-4584

Mailing address

11814 SW 96TH Ter
Miami, FL 33186-2720
Phone (305) 968-0861

Other practice location 1

1 Oakwood Blvd Ste 130
Hollywood, FL 33020-1937
Phone (954) 925-3844

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
SA17394FLMDSpeech-Language Pathologist
SZ8829FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1536883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1417430422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11814 SW 96TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331862720",
            "telephone_number": "305-968-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12030 SW 129TH CT STE 209",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864584",
            "telephone_number": "786-429-3619"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Oakwood Blvd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330201937",
            "country_code": "US",
            "telephone_number": "954-925-3844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ECKARDT",
        "first_name": "JENNIFER",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-14",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA17394",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ8829",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.