Individual provider Active NPI

Karen Sue Prince, MS,CCC-SLP/L

  • Speech-Language Pathologist
  • Cape Coral, FL
National Provider Identifier
1548665144
Registry record updated Oct 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA12284 Issued in FL
Practice address
2436 Woodbourne PL
Cape Coral, FL 33991-3069
Phone
(217) 791-2702
NPI assigned
Oct 27, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2014

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 SA12284 FL Primary

Addresses

Primary practice location

2436 Woodbourne PL
Cape Coral, FL 33991-3069

Mailing address

2436 Woodbourne PL
Cape Coral, FL 33991-3069
Phone (217) 791-2702

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SA12284FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Select Rehab St Louis LLC Past Accepting new patients

Organizations & group practices 1

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": "1414368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414368000000",
    "number": "1548665144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2436 WOODBOURNE PL",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339913069",
            "telephone_number": "217-791-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2436 WOODBOURNE PL",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339913069",
            "telephone_number": "217-791-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "KAREN",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "MS,CCC-SLP/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-27",
        "last_updated": "2014-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA12284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; 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.