Landon Dale Blood, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7944 Issued in LA

Practice address

202 W 3Rd St
Deridder, LA 70634-4026

Phone

(936) 671-9162

NPI assigned

Aug 8, 2022

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 8, 2022.

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1700513835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 W 3RD ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344026",
            "telephone_number": "936-671-9162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 W 3RD ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344026",
            "telephone_number": "936-671-9162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOD",
        "first_name": "LANDON",
        "middle_name": "DALE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "7944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Deridder, LA
• Speech-Language Pathologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.