Individual provider Active NPI

Gessica Vilma Burns

  • Speech-Language Pathologist
  • Jacksonville Beach, FL
National Provider Identifier
1639597495
Registry record updated Mar 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA11470 Issued in FL
Practice address
1212 13TH St N
Jacksonville Beach, FL 32250-3682
Phone
(727) 741-3405
NPI assigned
Mar 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2014

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 SA11470 FL Primary

Addresses

Primary practice location

1212 13TH St N
Jacksonville Beach, FL 32250-3682

Mailing address

12655 Agatite Rd
Jacksonville, FL 32258-2303
Phone (904) 588-5296

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

State licenses

LicenseStateTypeSpecialty
SA11470FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1396137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396137600000",
    "number": "1639597495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12655 AGATITE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322582303",
            "telephone_number": "904-588-5296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 13TH ST N",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503682",
            "telephone_number": "727-741-3405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNS",
        "first_name": "GESSICA",
        "middle_name": "VILMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-30",
        "last_updated": "2014-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA11470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2014; 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.