Active NPI
Gail Lynn Walter, M.S., SLP-CCC
- Speech-Language Pathologist
- Cocoa, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA12232
- Practice address
- 4555 Showdow St
Cocoa, FL 32926-2807 - Phone
- (321) 626-7777
- NPI assigned
- Aug 6, 2012
- Last updated
- Oct 21, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SZ5682 | FL | |
| Speech-Language Pathologist | 235Z00000X | SA12232 | FL | Primary |
Addresses
Primary practice location
4555 Showdow St
Cocoa, FL 32926-2807
Mailing address
4555 Showdow St
Cocoa, FL 32926-2807
Phone (321) 626-7777
Other names 1
- Gail Lynn Johnson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
107 Longwood Ave
Rockledge, FL 32955-2827
Phone (321) 338-2419
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA12232 | FL | MD | Speech-Language Pathologist |
| SZ5682 | FL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Speech Avenues Therapy Co | Speech-Language Pathologist | Current | Accepting new patients |
Locations
1071 Port Malabar Blvd NE
Ste 206
Palm Bay, FL 32905
107 Longwood Ave
Rockledge, FL 32955
Phone (321) 338-2419
1237 Florida Ave S
Rockledge, FL 32955
Phone (321) 338-2419
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634774400000",
"number": "1720335052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4555 SHOWDOW ST",
"city": "COCOA",
"state": "FL",
"postal_code": "329262807",
"telephone_number": "321-626-7777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4555 SHOWDOW ST",
"city": "COCOA",
"state": "FL",
"postal_code": "329262807",
"telephone_number": "321-626-7777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTER",
"first_name": "GAIL",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "M.S., SLP-CCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-06",
"last_updated": "2021-10-21",
"certification_date": "2021-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SZ5682",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA12232",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "GAIL",
"last_name": "JOHNSON",
"middle_name": "LYNN",
"credential": "M.S., SLP-CCC",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Cocoa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.