Individual provider Active NPI

Nicole Batista

  • Speech-Language Pathologist
  • Doral, FL
National Provider Identifier
1528419900
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA20024 Issued in FL
Practice address
10200 NW 25TH St
Doral, FL 33172-5921
Phone
(786) 717-5649
Fax
(786) 717-5754
NPI assigned
Jun 27, 2016
Last updated
Mar 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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 SA20024 FL Primary

Addresses

Primary practice location

10200 NW 25TH St
Doral, FL 33172-5921

Mailing address

10200 NW 25TH St
Doral, FL 33172-5921
Phone (786) 717-5649

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230809001783 FL Practitioner - Qualified Speech Language Pathologist 5496117392 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SA20024FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince Jul 24, 2023 Accepting new patients
Legacy Healthcare Services, Inc Speech-Language Pathologist CurrentSince Jul 24, 2023 Accepting new patients

Locations

2219 Chiquita Blvd S
Cape Coral, FL 33991
Phone (239) 205-3654

9101 SW 24th St
Miami, FL 33165
Phone (305) 330-6698

8213 Killearn Lakes Ter
Tallahassee, FL 32312
Phone (850) 391-0979

38130 Pretty Pond Rd
Zephyrhills, FL 33540
Phone (813) 400-2291

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (919) 861-2441

Organizations & group practices 2

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": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1528419900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 NW 25TH ST",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331725921",
            "telephone_number": "786-717-5649",
            "fax_number": "786-717-5754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 NW 25TH ST",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331725921",
            "telephone_number": "786-717-5649",
            "fax_number": "786-717-5754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATISTA",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-27",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA20024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.