Individual provider Active NPI

Elham Demery Zamora, SLP

  • Speech-Language Pathologist
  • Gainesville, FL
National Provider Identifier
1427457100
Registry record updated Jan 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA7785 Issued in FL
Practice address
4631 NW 53Rd Ave Ste 102
Gainesville, FL 32653-3402
Phone
(352) 359-7958
NPI assigned
Aug 19, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2022

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 SA7785 FL Primary

Addresses

Primary practice location

4631 NW 53Rd Ave Ste 102
Gainesville, FL 32653-3402

Mailing address

9170 SE 2ND Street Rd
Trenton, FL 32693-4771
Phone (352) 359-7958

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150506002605 FL Practitioner - Qualified Speech Language Pathologist 8325367717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4631 NW 53Rd Ave
Suite 102
Gainesville, FL 32653-3402
Phone (352) 440-8147

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SA7785FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Divine Speech and Swallowing Solutions LLC Speech-Language Pathologist CurrentSince Feb 11, 2022 Accepting new patients

Locations

4631 NW 53rd Ave
Ste 102
Gainesville, FL 32653
Phone (352) 359-7958

Organizations & group practices 1

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": "1408406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641081600000",
    "number": "1427457100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9170 SE 2ND STREET RD",
            "city": "TRENTON",
            "state": "FL",
            "postal_code": "326934771",
            "telephone_number": "352-359-7958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4631 NW 53RD AVE STE 102",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326533402",
            "telephone_number": "352-359-7958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAMORA",
        "first_name": "ELHAM",
        "middle_name": "DEMERY",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-19",
        "last_updated": "2022-01-02",
        "certification_date": "2021-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA7785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.