NPIMap

Organization Active NPI

Picky Eaters Online Inc

  • Speech-Language Pathologist
  • Saint Cloud, FL
National Provider Identifier
1780350025
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
PICKY EATERS ONLINE INC
Doing business as
Picky Eaters Online INC
Practice address
5030 Hartwell CT
Saint Cloud, FL 34771-7936
Phone
(321) 388-2924
NPI assigned
Aug 17, 2021
Last updated
Aug 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kelly Komisaruk, M.ED, CCC-SLPNPI 1831414804
Title
President
Phone
(321) 388-2924

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary
Hearing and Speech Clinic/Center 261QH0700X

Addresses

Primary practice location

5030 Hartwell CT
Saint Cloud, FL 34771-7936

Mailing address

5030 Hartwell CT
Saint Cloud, FL 34771-7936
Phone (321) 388-2924

Other names 1

  • Picky Eaters Online INC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629158400000",
    "number": "1780350025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 HARTWELL CT",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347717936",
            "telephone_number": "321-388-2924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 HARTWELL CT",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347717936",
            "telephone_number": "321-388-2924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PICKY EATERS ONLINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-17",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A",
        "authorized_official_last_name": "KOMISARUK",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-388-2924",
        "authorized_official_credential": "M.ED, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Picky Eaters Online INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Cloud, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; 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.