Individual provider Active NPI

Cedrick Quickley

  • Speech-Language Pathologist
  • Fort Pierce, FL
National Provider Identifier
1629514419
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SI3112 Issued in FL
Practice address
5407 Killarney Ave
Fort Pierce, FL 34951-5002
Phone
(772) 480-3759
NPI assigned
Jan 17, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

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 SI3112 FL Primary

Addresses

Primary practice location

5407 Killarney Ave
Fort Pierce, FL 34951-5002

Mailing address

5407 Killarney Ave
Fort Pierce, FL 34951-5002
Phone (772) 480-3759

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260219000406 FL Practitioner - Qualified Speech Language Pathologist 3476033283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

110 Winding Rock Rd
Simpsonville, SC 29680-2486

PO Box
Suite 470724
Broadview Heights, OH 44147

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SI3112FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ap Therapy LLC Speech-Language Pathologist CurrentSince Feb 16, 2026 Accepting new patients
Ap Therapy LLC Speech-Language Pathologist CurrentSince Feb 16, 2026 Accepting new patients

Locations

1297 US Highway 27 N
Lake Placid, FL 33852
Phone (407) 276-5023

5501 E Michigan St
Orlando, FL 32822
Phone (407) 277-7225

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1629514419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5407 KILLARNEY AVE",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349515002",
            "telephone_number": "772-480-3759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5407 KILLARNEY AVE",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349515002",
            "telephone_number": "772-480-3759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUICKLEY",
        "first_name": "CEDRICK",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-17",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SI3112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.