Individual provider Active NPI

Audrey Smith Ballin

  • Speech-Language Pathologist
  • Orlando, FL
National Provider Identifier
1487173852
Registry record updated Sep 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA1979 Issued in FL
Practice address
730 Courtland St
Orlando, FL 32804-1316
Phone
(407) 975-3800
NPI assigned
Sep 16, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2017

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 SA1979 FL Primary

Addresses

Primary practice location

730 Courtland St
Orlando, FL 32804-1316

Mailing address

1102 Pine Oaks CT
Apopka, FL 32712-3720

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
SA1979FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1505520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505520000000",
    "number": "1487173852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 PINE OAKS CT",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327123720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 COURTLAND ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328041316",
            "telephone_number": "407-975-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLIN",
        "first_name": "AUDREY",
        "middle_name": "SMITH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-16",
        "last_updated": "2017-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA1979",
            "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 Sep 16, 2017; 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.