Individual provider Active NPI

Kristin Nicole Corron, MS,SLP

  • Speech-Language Pathologist
  • Winter Garden, FL
National Provider Identifier
1508139486
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA12264 Issued in FL
Practice address
886 S Dillard St
Winter Garden, FL 34787-3910
Phone
(407) 905-8908
Fax
(407) 905-8958
NPI assigned
Feb 22, 2012
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 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 SZ5732 FL
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X SA12264 FL Primary

Addresses

Primary practice location

886 S Dillard St
Winter Garden, FL 34787-3910

Mailing address

940 Douglas Ave Unit 135
Altamonte Springs, FL 32714-2096
Phone (321) 439-5888

Other identifiers 1

IdentifierTypeStateIssuer
004705300MedicaidFL

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
SA12264FLMDSpeech-Language Pathologist
SZ5732FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Therapy Services of Greater Orlando, LLC Speech-Language Pathologist PastSince Oct 1, 2023 Accepting new patients
Kids Connection Therapy LLC Speech-Language Pathologist Past Accepting new patients
Speech Innovations of Central Florida LLC Single Specialty Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1329868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1508139486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 DOUGLAS AVE UNIT 135",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327142096",
            "telephone_number": "321-439-5888",
            "fax_number": "407-905-8958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "886 S DILLARD ST",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873910",
            "telephone_number": "407-905-8908",
            "fax_number": "407-905-8958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORRON",
        "first_name": "KRISTIN",
        "middle_name": "NICOLE",
        "credential": "MS,SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ5732",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA12264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004705300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.