Individual provider Active NPI

Karyn E Pennington, M.S., CCC/SLP

  • Speech-Language Pathologist
  • Orlando, FL
National Provider Identifier
1467473967
Registry record updated Nov 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 8133 Issued in FL
Practice address
7380 W Sand Lake Rd
Suite 500
Orlando, FL 32819-5248
Phone
(407) 905-9300
Fax
(407) 905-9309
NPI assigned
Jul 21, 2006
Last updated
Nov 12, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2015

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 SA 8133 FL Primary
Developmental Therapist 222Q00000X SA 8133 FL

Addresses

Primary practice location

7380 W Sand Lake Rd
Suite 500
Orlando, FL 32819-5248

Mailing address

1908 Varick Way
Casselberry, FL 32707-2409
Phone (407) 905-9300

Other identifiers 1

IdentifierTypeStateIssuer
015687100MedicaidFL

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SA 8133FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447286400000",
    "number": "1467473967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 VARICK WAY",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "327072409",
            "telephone_number": "407-905-9300",
            "fax_number": "407-905-9309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7380 W SAND LAKE RD",
            "address_2": "SUITE 500",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328195248",
            "telephone_number": "407-905-9300",
            "fax_number": "407-905-9309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "KARYN",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2015-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 8133",
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "FL",
            "license": "SA 8133",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015687100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; 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.