Crystal Moore Koppal, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA8120 Issued in FL

Practice address

1034 NW 57TH St
Suite C
Gainesville, FL 32605-6452

Phone

(352) 332-9015

Fax

(352) 332-9941

NPI assigned

May 18, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1619185048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 NW 28TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072565",
            "telephone_number": "352-371-1865",
            "fax_number": "352-332-9941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 NW 57TH ST",
            "address_2": "SUITE C",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326056452",
            "telephone_number": "352-332-9015",
            "fax_number": "352-332-9941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPPAL",
        "first_name": "CRYSTAL",
        "middle_name": "MOORE",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA8120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol C Koogler, R.N.
• Avon Koon
• Lorraine Koon
• Jay Clyde Koons, MD
• Kaylyn Elise Koons, RD, LD
• Scott Koppel, D.P.M.
• Tessy Korah, MD
• Akemi V Korahais, DOM
• Michael J Koren, M.D.
• Harriet Kornblatt, RPH, BCGP

• Speech-Language Pathologist in Gainesville, FL
• Providers in Gainesville, 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 Jul 9, 2007; 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.