Individual provider Active NPI

Elizabeth (Betsy) Ann Thorn, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Lake Worth, FL
National Provider Identifier
1619171097
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA6337 Issued in FL
Practice address
3898 Via Poinciana Ste 17
Lake Worth, FL 33467-2951
Phone
(561) 376-2573
NPI assigned
Jun 12, 2007
Last updated
Oct 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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 SA6337 FL Primary

Addresses

Primary practice location

3898 Via Poinciana Ste 17
Lake Worth, FL 33467-2951

Mailing address

101 Eaton Dr
Middletown, OH 45044-4905
Phone (321) 795-7745

Other practice location 1

5650 South Washington Ave
Titusville, FL 32780
Phone (321) 264-9331

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 Arts

State licenses

LicenseStateTypeSpecialty
SA6337FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Pediatric Therapy, Inc. PastSince Oct 9, 2022 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1619171097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 EATON DR",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450444905",
            "telephone_number": "321-795-7745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3898 VIA POINCIANA STE 17",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334672951",
            "telephone_number": "561-376-2573"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5650 South Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Titusville",
            "state": "FL",
            "postal_code": "32780",
            "country_code": "US",
            "telephone_number": "321-264-9331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THORN",
        "first_name": "ELIZABETH (BETSY)",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA6337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.