Individual provider Active NPI

Ellen Leger, SLP

  • Speech-Language Pathologist
  • Brandon, FL
National Provider Identifier
1679943641
Registry record updated Oct 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA3527 Issued in FL
Practice address
602 Vonderburg Dr Suite 204
Brandon, FL 33511
Phone
(863) 617-9400
Fax
(863) 688-9858
NPI assigned
Oct 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2015

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 SA3527 FL Primary

Addresses

Primary practice location

602 Vonderburg Dr Suite 204
Brandon, FL 33511

Mailing address

602 Vonderburg Dr Suite 204
Brandon, FL 33511
Phone (863) 617-9400

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
SA3527FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1443744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443744000000",
    "number": "1679943641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 VONDERBURG DR SUITE 204",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "33511",
            "telephone_number": "863-617-9400",
            "fax_number": "863-688-9858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 VONDERBURG DR SUITE 204",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "33511",
            "telephone_number": "863-617-9400",
            "fax_number": "863-688-9858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGER",
        "first_name": "ELLEN",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-02",
        "last_updated": "2015-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA3527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; 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.