Active NPI
Marcquitta Head
- Early Intervention Provider Agency
- St Augustine, FL
National Provider Identifier
1558853499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Early Intervention Provider Agency
- Practice address
- 56 Water St
St Augustine, FL 32084-2887 - Phone
- (727) 364-4024
- NPI assigned
- Jun 6, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | |||
| Early Intervention Provider Agency | 252Y00000X | Primary |
Addresses
Primary practice location
56 Water St
St Augustine, FL 32084-2887
Mailing address
875 Derbyshire Rd Apt 278
Daytona Beach, FL 32117-3964
Phone (404) 748-2425
Other practice location 1
875 Derbyshire Rd
Daytona Beach, FL 32117-3968
Phone (404) 748-2425
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1283937 | Other | FL | TEACHING CERTIFICATE |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Talk of the Town Speech Therapy LLC | Current | Accepting new patients | |
| Talk of the Town Speech Therapy LLC | Early Intervention Provider Agency | Past | Accepting new patients |
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.
-
- Speech-Language Pathologist
- St Augustine, FL
- NPI 1689063216
-
- Early Intervention Provider Agency
- St Augustine, FL
- NPI 1649705419
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585612800000",
"number": "1558853499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "875 DERBYSHIRE RD APT 278",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321173964",
"telephone_number": "404-748-2425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "56 WATER ST",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320842887",
"telephone_number": "727-364-4024"
}
],
"practiceLocations": [
{
"address_1": "875 Derbyshire Rd",
"address_purpose": "LOCATION",
"city": "Daytona Beach",
"state": "FL",
"postal_code": "321173968",
"country_code": "US",
"telephone_number": "404-748-2425",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HEAD",
"first_name": "MARCQUITTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-06",
"last_updated": "2020-03-31",
"certification_date": "2020-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "252Y00000X",
"taxonomy_group": "",
"desc": "Early Intervention Provider Agency",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEACHING CERTIFICATE",
"identifier": "1283937",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in St Augustine, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.