Individual provider Active NPI

Anna Moon Farrell, MS., CCC-SLP

  • Speech-Language Pathologist
  • St Augustine, FL
National Provider Identifier
1780490649
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA15779 Issued in FL
Practice address
105 Mariner Health Way Ste 213
St Augustine, FL 32086-3251
Phone
(904) 217-4259
Fax
(904) 217-4251
NPI assigned
Dec 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

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 SA15779 FL Primary

Addresses

Primary practice location

105 Mariner Health Way Ste 213
St Augustine, FL 32086-3251

Mailing address

5B Sylvan Dr
Saint Augustine, FL 32084-2121
Phone (904) 610-4025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260213000137 FL Practitioner - Qualified Speech Language Pathologist 0648750323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Augustine Rehabilitation Specialists LLCGroup PAC ID 8426107293, 38 clinicians

Practice addresses (Care Compare)

105 Mariner Health Way
Suite 213
St Augustine, FL 32086-3251
Phone (904) 217-4259

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SA15779FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Augustine Rehabilitation Specialists LLC CurrentSince Feb 9, 2026 Accepting new patients
Saint Augustine Rehabilitation Specialists LLC Speech-Language Pathologist CurrentSince Feb 9, 2026 Accepting new patients

Locations

1711 Lakeside Ave
Ste 3
Saint Augustine, FL 32084
Phone (904) 201-1080

105 Mariner Health Way
Ste 213
St Augustine, FL 32086
Phone (904) 217-4259

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": "1733356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770768000000",
    "number": "1780490649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5B SYLVAN DR",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320842121",
            "telephone_number": "904-610-4025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MARINER HEALTH WAY STE 213",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320863251",
            "telephone_number": "904-217-4259",
            "fax_number": "904-217-4251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON FARRELL",
        "first_name": "ANNA",
        "credential": "MS., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-05",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA15779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; 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.

Verify at the official NPI Registry.