Individual provider Active NPI

Susan Dudley, MA, CCC-SLP

  • Speech-Language Pathologist
  • Fort Pierce, FL
National Provider Identifier
1730367442
Registry record updated Feb 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA7183 Issued in FL
Practice address
4202 Okeechobee Rd
Fort Pierce, FL 34947-5414
Phone
(772) 462-6636
Fax
(772) 462-6636
NPI assigned
Feb 5, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2008

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 SA7183 FL Primary

Addresses

Primary practice location

4202 Okeechobee Rd
Fort Pierce, FL 34947-5414

Mailing address

4202 Okeechobee Rd
Fort Pierce, FL 34947-5414
Phone (772) 462-6636

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 Arts

State licenses

LicenseStateTypeSpecialty
SA7183FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
A Plus Speech Therapy Professionals, Inc. Speech-Language Pathologist Past Accepting new patients
A Plus Associated Therapy Professionals Inc Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202169600000",
    "number": "1730367442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4202 OKEECHOBEE RD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349475414",
            "telephone_number": "772-462-6636",
            "fax_number": "772-462-6636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4202 OKEECHOBEE RD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349475414",
            "telephone_number": "772-462-6636",
            "fax_number": "772-462-6636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "SUSAN",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-05",
        "last_updated": "2008-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA7183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; 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.