Kaley Peterman, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA13895 Issued in FL

Practice address

12627 San Jose Blvd Ste 803
Jacksonville, FL 32223-8644

Phone

(904) 460-4951

NPI assigned

Dec 22, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1640131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1467112011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "862 GLENNEYRE CIR",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320921231",
            "telephone_number": "904-460-4951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12627 SAN JOSE BLVD STE 803",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238644",
            "telephone_number": "904-460-4951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERMAN",
        "first_name": "KALEY",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-22",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA13895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Perspectives Anew Therapy LLC
• Joseph Pesek III, M.D.
• Jodi Petchauer, WHNP
• Peter a. Nassar, M.D., P.a.
• Peter L Kovacs MD PA
• Bryce Peters, ATC, LAT
• Chloe Marlies Peters, LCSW
• Cory Grant Peters, PA
• Elizabeth Peters
• Jessica Dwan Peters, MS, ATC, LAT, PES

• Speech-Language Pathologist in Jacksonville, FL
• Providers in Jacksonville, 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 Dec 22, 2021; 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.