NPIMap

Organization Active NPI

Kidtalk, P.a.

  • Speech-Language Pathologist
  • Starke, FL
National Provider Identifier
1528006178
Registry record updated Feb 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA5788 Issued in FL
Legal business name
KIDTALK, P.A.
Practice address
417 W Call St
Starke, FL 32091-3115
Phone
(904) 964-4464
NPI assigned
Jun 4, 2006
Last updated
Feb 5, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Aimee JenningsNPI 1427022631
Title
President
Phone
(904) 964-4464

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X NU
Occupational Therapist 225X00000X OT 8454 FL
Pediatric Occupational Therapist 225XP0200X NU
Speech-Language Pathologist 235Z00000X SA5788 FL Primary
Developmental Therapist 222Q00000X NU

Addresses

Primary practice location

417 W Call St
Starke, FL 32091-3115

Mailing address

2162 NE 154TH St
Starke, FL 32091-6418

Other identifiers 4

IdentifierTypeStateIssuer
811712800MedicaidFL
Y928VOtherFLBLUE CROSS
T0929OtherFLBLUE CROSS
889841300MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Kidtalk PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

417 W Call St
Starke, FL 32091
Phone (904) 368-0641

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233792000000",
    "number": "1528006178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2162 NE 154TH ST",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320916418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 W CALL ST",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320913115",
            "telephone_number": "904-964-4464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDTALK, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2009-02-05",
        "status": "A",
        "authorized_official_last_name": "JENNINGS",
        "authorized_official_first_name": "AIMEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-964-4464",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT 8454",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA5788",
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "811712800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "Y928V",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "T0929",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "889841300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Starke, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; 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.