Individual provider Active NPI

Cassie Leigh Capri

  • Speech-Language Pathologist
  • Orange Park, FL
National Provider Identifier
1477030260
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA18851 Issued in FL
Practice address
784 Blanding Blvd Ste 108
Orange Park, FL 32065-7724
Phone
(904) 264-2636
NPI assigned
Jul 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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 25423 CA
Speech-Language Pathologist 235Z00000X SA18851 FL Primary

Addresses

Primary practice location

784 Blanding Blvd Ste 108
Orange Park, FL 32065-7724

Mailing address

1217 Paradise Pond Rd
Saint Augustine, FL 32092-0790
Phone (631) 790-7688

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
25423CAMDSpeech-Language Pathologist
SA18851FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1477030260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 PARADISE POND RD",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320920790",
            "telephone_number": "631-790-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 BLANDING BLVD STE 108",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320657724",
            "telephone_number": "904-264-2636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPRI",
        "first_name": "CASSIE",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-24",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "25423",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA18851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.