Individual provider Active NPI

Nikisha Peterson, CF-SLP

  • Speech-Language Pathologist
  • Winter Springs, FL
National Provider Identifier
1780008623
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
20570 Issued in FL
Practice address
300 Sheoah Blvd Apt 801
Winter Springs, FL 32708-5316
Phone
(407) 223-6451
NPI assigned
Feb 12, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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 20570 FL Primary

Addresses

Primary practice location

300 Sheoah Blvd Apt 801
Winter Springs, FL 32708-5316

Mailing address

300 Sheoah Blvd Apt 801
Winter Springs, FL 32708-5316
Phone (407) 223-6451

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

LicenseStateTypeSpecialty
20570FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1392163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1780008623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SHEOAH BLVD APT 801",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327085316",
            "telephone_number": "407-223-6451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SHEOAH BLVD APT 801",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327085316",
            "telephone_number": "407-223-6451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "NIKISHA",
        "credential": "CF-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-12",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "20570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.