Active NPI
Nicole Vanessa Gregory, M. ED CCC - SLP
- Speech-Language Pathologist
- Deltona, FL
National Provider Identifier
1770790966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA 8308
- Practice address
- 1565 Saxon Blvd
Suite 301
Deltona, FL 32725-5876 - Phone
- (386) 851-0901
- NPI assigned
- May 17, 2007
- 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 | SA 8308 | FL | Primary |
Addresses
Primary practice location
1565 Saxon Blvd
Suite 301
Deltona, FL 32725-5876
Mailing address
522 Wilton Cir
Sanford, FL 32773-4910
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA 8308 | FL | MD | Speech-Language Pathologist |
Networks
- Optimum HealthCare HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770790966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "522 WILTON CIR",
"city": "SANFORD",
"state": "FL",
"postal_code": "327734910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1565 SAXON BLVD",
"address_2": "SUITE 301",
"city": "DELTONA",
"state": "FL",
"postal_code": "327255876",
"telephone_number": "386-851-0901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREGORY",
"first_name": "NICOLE",
"middle_name": "VANESSA",
"credential": "M. ED CCC - SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA 8308",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deltona, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.