Active NPI
Reva Fedigan
- Speech-Language Pathologist
- Orlando, FL
National Provider Identifier
1467591503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA4398
- Practice address
- 1836 Woodward St
Orlando, FL 32803-4256 - Phone
- (407) 872-3378
- NPI assigned
- Feb 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA4398 | FL | Primary |
Addresses
Primary practice location
1836 Woodward St
Orlando, FL 32803-4256
Mailing address
13217 Sharswood Cir
Orlando, FL 32828-7726
Phone (407) 716-7524
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
| License | State | Type | Specialty |
|---|---|---|---|
| SA4398 | FL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Hospital Colorado | Current | Accepting new patients |
Interoperability endpoints
- rfedigan236191@direct.childrenscolorado.org
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.
-
- Clinical Social Worker
- Aurora, CO
- NPI 1174282776
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1467591503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13217 SHARSWOOD CIR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328287726",
"telephone_number": "407-716-7524",
"fax_number": "407-207-5895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1836 WOODWARD ST",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328034256",
"telephone_number": "407-872-3378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEDIGAN",
"first_name": "REVA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-05",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA4398",
"primary": true
}
],
"identifiers": [],
"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 Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.