Active NPI
Gretchen A Lavergne, M.S., CCC-SLP
- Speech-Language Pathologist
- Jacksonville, FL
National Provider Identifier
1710626148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA3078
- Practice address
- 8700 A C Skinner Pkwy
Jacksonville, FL 32256-0836 - Phone
- (904) 642-7300
- NPI assigned
- Jun 2, 2022
- Sex
- Female
- Sole proprietor
- No
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 | SA3078 | FL | Primary |
Addresses
Primary practice location
8700 A C Skinner Pkwy
Jacksonville, FL 32256-0836
Mailing address
9803 Creekfront Rd Apt 901
Jacksonville, FL 32256-6710
Phone (904) 521-4833
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA3078 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654128000000",
"number": "1710626148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9803 CREEKFRONT RD APT 901",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322566710",
"telephone_number": "904-521-4833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8700 A C SKINNER PKWY",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322560836",
"telephone_number": "904-642-7300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAVERGNE",
"first_name": "GRETCHEN",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-02",
"last_updated": "2022-06-02",
"certification_date": "2022-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA3078",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.