Nicole Susan Greathouse

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SZ4640 Issued in FL

Practice address

3019 Lazlo LN
Orlando, FL 32837-7312

Phone

(321) 662-3777

NPI assigned

Oct 10, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Nicole Susan Tardif Former name

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.

{
    "created_epoch": "1223596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394582400000",
    "number": "1710138516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3019 LAZLO LN",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328377312",
            "telephone_number": "321-662-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3019 LAZLO LN",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328377312",
            "telephone_number": "321-662-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREATHOUSE",
        "first_name": "NICOLE",
        "middle_name": "SUSAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-10",
        "last_updated": "2014-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ4640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "TARDIF",
            "middle_name": "SUSAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Greater Orlando Neursurgery and Spine
• Greater Orlando Outpatient Center
• Greater Orlando Psychiatric Associates, P.a.
• Greater Orlando Surgical Group, LLC
• Greater Tomorrow Counseling and Consulting Services/Cleane St Eloi
• Luz Denise Greaux
• Deborah I Greaves, MD
• Carley Greco, MD
• Christina Rose Greco, M.A., BCBA
• Jennifer Greco, OT12345

• Speech-Language Pathologist in Orlando, FL
• Providers in Orlando, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.