Courtney Clemmons

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SZ8700 Issued in FL

Practice address

2 Coleman Dr
St Augustine, FL 32084-2873

Phone

(727) 967-1036

NPI assigned

Aug 30, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Talk of the Town Speech Therapy LLC

  • Early Intervention Provider Agency
  • St Augustine, FL
  • NPI 1649705419
  NPD (past)
• Talk of the Town Speech Therapy LLC

  • Speech-Language Pathologist
  • St Augustine, FL
  • NPI 1689063216
  NPD (past)

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1578045167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 COLEMAN DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320842873",
            "telephone_number": "727-967-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 COLEMAN DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320842873",
            "telephone_number": "727-967-1036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMMONS",
        "first_name": "COURTNEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-30",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ8700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA DEPARTMENT OF HEALTH",
            "identifier": "SZ8700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; 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.