Active NPI
Alexa Prendergast
- Speech-Language Pathologist
- Fort Myers, FL
National Provider Identifier
1679180236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SZ9825
- Practice address
- 4048 Evans Ave
Fort Myers, FL 33901-9322 - Phone
- (239) 479-5093
- NPI assigned
- Sep 28, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SZ9825 | FL | Primary |
Addresses
Primary practice location
4048 Evans Ave
Fort Myers, FL 33901-9322
Mailing address
9301 Central Park Dr Apt 202
Fort Myers, FL 33919-4843
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
| License | State | Type | Specialty |
|---|---|---|---|
| SZ9825 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601251200000",
"number": "1679180236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9301 CENTRAL PARK DR APT 202",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339194843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4048 EVANS AVE",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339019322",
"telephone_number": "239-479-5093"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRENDERGAST",
"first_name": "ALEXA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-28",
"last_updated": "2020-09-28",
"certification_date": "2020-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SZ9825",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.