Ryann Vanessa Ennis, SPEECH/LANGUAGE PATH

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA8416 Issued in FL

Practice address

1005 Mar Walt Drive
Otolaryngology Department
Fort Walton Beach, FL 32547-6796

Phone

(850) 863-8275

Fax

(850) 314-6833

NPI assigned

Oct 20, 2009

Sex

Female

Sole proprietor

No

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)

Enrolled

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255996800000",
    "number": "1629304027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 MAR WALT DRIVE",
            "address_2": "OTOLARYNGOLOGY DEPARTMENT",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476796",
            "telephone_number": "850-863-8275",
            "fax_number": "850-314-6833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 MAR WALT DRIVE",
            "address_2": "OTOLARYNGOLOGY DEPARTMENT",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476796",
            "telephone_number": "850-863-8275",
            "fax_number": "850-314-6833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "RYANN",
        "middle_name": "VANESSA",
        "credential": "SPEECH/LANGUAGE PATH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-20",
        "last_updated": "2009-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA8416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emergency Providers Group LLC
• Empower Today Therapy LLC
• Encore Rehabilitation Inc (Encore Rehab of Fort Walton Beach)
• Encore Rehabilitation Inc
• Zadie Mae Engelberger, PA
• Tara Rexanne Ennis, MD
• Epifani LLC (1 Heart Care Solutions)
• Sara Kelly Erdwins, PA-C
• David Alan Erickson, MD
• Samantha Ervin, APRN

• Speech-Language Pathologist in Fort Walton Beach, FL
• Providers in Fort Walton Beach, 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 Oct 20, 2009; 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.