Active NPI
Victoria Penn, MS CCC-SLP
- Speech-Language Pathologist
- Naples, FL
National Provider Identifier
1811217508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA 10710
- Practice address
- 1290 Sperling CT
Naples, FL 34103-2328 - Phone
- (239) 580-8884
- NPI assigned
- Jun 4, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SL003512L | PA | |
| Speech-Language Pathologist | 235Z00000X | SA 10710 | FL | Primary |
Addresses
Primary practice location
1290 Sperling CT
Naples, FL 34103-2328
Mailing address
1290 Sperling CT
Naples, FL 34103-2328
Phone (239) 580-8884
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SL003512L | Other | PA | BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS |
| SA 10710 | Other | FL | STATE OF FLORIDA DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE |
| 01101838 | Other | MD | AMERICAN SPEECH-LNAGUAGE-HEARING ASSOCIATION |
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SL003512L | PA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294617600000",
"number": "1811217508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1290 SPERLING CT",
"city": "NAPLES",
"state": "FL",
"postal_code": "341032328",
"telephone_number": "239-580-8884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1290 SPERLING CT",
"city": "NAPLES",
"state": "FL",
"postal_code": "341032328",
"telephone_number": "239-580-8884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENN",
"first_name": "VICTORIA",
"name_prefix": "Ms.",
"credential": "MS CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-04",
"last_updated": "2011-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "PA",
"license": "SL003512L",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA 10710",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS",
"identifier": "SL003512L",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF FLORIDA DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE",
"identifier": "SA 10710",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN SPEECH-LNAGUAGE-HEARING ASSOCIATION",
"identifier": "01101838",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Naples, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.