Active NPI
Jennifer Porter, MA, CCC-SLP
- Speech-Language Pathologist
- Longwood, FL
National Provider Identifier
1497779268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA7021
- Practice address
- 1060 W State Road 434
Suite 108
Longwood, FL 32750-4919 - Phone
- (407) 260-0551
- Fax
- (407) 265-9590
- NPI assigned
- Jul 26, 2006
- Sex
- Female
- Sole proprietor
- No
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 | SA7021 | FL | Primary |
Addresses
Primary practice location
1060 W State Road 434
Suite 108
Longwood, FL 32750-4919
Mailing address
224 Chestnut Creek Dr
Apopka, FL 32703-4866
Phone (407) 260-0551
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 888846900 | Medicaid | FL |
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA7021 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497779268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 CHESTNUT CREEK DR",
"city": "APOPKA",
"state": "FL",
"postal_code": "327034866",
"telephone_number": "407-260-0551",
"fax_number": "407-265-9590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1060 W STATE ROAD 434",
"address_2": "SUITE 108",
"city": "LONGWOOD",
"state": "FL",
"postal_code": "327504919",
"telephone_number": "407-260-0551",
"fax_number": "407-265-9590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "JENNIFER",
"credential": "MA, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA7021",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "888846900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Longwood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.