Individual provider Active NPI

Lauren Reynolds Fife

  • Speech-Language Pathologist
  • Lakeland, FL
National Provider Identifier
1528504255
Registry record updated Mar 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SZ7942 Issued in FL
Practice address
1818 Harden Blvd Ste 160
Lakeland, FL 33803-1824
Phone
(863) 683-4726
NPI assigned
Jan 19, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2020

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 SZ7942 FL Primary

Addresses

Primary practice location

1818 Harden Blvd Ste 160
Lakeland, FL 33803-1824

Mailing address

1818 Harden Blvd Ste 160
Lakeland, FL 33803-1824
Phone (863) 683-4726

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211009000040 FL Practitioner - Qualified Speech Language Pathologist 2062810708 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SZ7942FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Speech & Hearing Center Speech-Language Pathologist CurrentSince Oct 24, 2021 Accepting new patients
Pediatric Therapy Services Inc Speech-Language Pathologist Past Accepting new patients

Locations

3020 Lakeland Highlands Rd
Lakeland, FL 33803
Phone (863) 686-3189

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583452800000",
    "number": "1528504255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 HARDEN BLVD STE 160",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338031824",
            "telephone_number": "863-683-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 HARDEN BLVD STE 160",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338031824",
            "telephone_number": "863-683-4726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIFE",
        "first_name": "LAUREN",
        "middle_name": "REYNOLDS",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-19",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ7942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2020; 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.