Individual provider Active NPI

Sharon S Kesler, B.S., CCC-SLP

  • Speech-Language Pathologist
  • Jacksonville, FL
National Provider Identifier
1598876591
Registry record updated Feb 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 1101 Issued in FL
Practice address
1128 N Laura St
Jacksonville, FL 32206-4912
Phone
(904) 355-3403
Fax
(904) 355-4149
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 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 SA 1101 FL Primary

Addresses

Primary practice location

1128 N Laura St
Jacksonville, FL 32206-4912

Mailing address

1128 N Laura St
Jacksonville, FL 32206-4912
Phone (904) 355-3403

Other identifiers 1

IdentifierTypeStateIssuer
8824908-00MedicaidFL

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
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
SA 1101FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393459200000",
    "number": "1598876591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1128 N LAURA ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322064912",
            "telephone_number": "904-355-3403",
            "fax_number": "904-355-4149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1128 N LAURA ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322064912",
            "telephone_number": "904-355-3403",
            "fax_number": "904-355-4149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESLER",
        "first_name": "SHARON",
        "middle_name": "S",
        "credential": "B.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 1101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8824908-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

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