Active NPI
Krista Scary, M.S. CCC-SLP
- Speech-Language Pathologist
- Brandon, FL
National Provider Identifier
1609538461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA20648
- Practice address
- 602 Vonderburg Dr Ste 201
Brandon, FL 33511-5900 - Phone
- (813) 653-1149
- NPI assigned
- Oct 8, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA20648 | FL | Primary |
Addresses
Primary practice location
602 Vonderburg Dr Ste 201
Brandon, FL 33511-5900
Mailing address
5150 Palm Valley Rd
Ponte Vedra, FL 32082-4629
Other practice location 1
5150 Palm Valley Rd
Ponte Vedra, FL 32082-4629
Phone (904) 616-3455
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA20648 | FL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Melanie Desmond | Speech-Language Pathologist | 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.
-
- Speech-Language Pathologist
- Ponte Vedra Beach, FL
- NPI 1104223395
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700006400000",
"number": "1609538461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5150 PALM VALLEY RD",
"city": "PONTE VEDRA",
"state": "FL",
"postal_code": "320824629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "602 VONDERBURG DR STE 201",
"city": "BRANDON",
"state": "FL",
"postal_code": "335115900",
"telephone_number": "813-653-1149"
}
],
"practiceLocations": [
{
"address_1": "5150 Palm Valley Rd",
"address_purpose": "LOCATION",
"city": "Ponte Vedra",
"state": "FL",
"postal_code": "320824629",
"country_code": "US",
"telephone_number": "904-616-3455",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SCARY",
"first_name": "KRISTA",
"credential": "M.S. CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-08",
"last_updated": "2023-11-15",
"certification_date": "2023-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA20648",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.