Active NPI
Alyssa Leblanc Davis, CF-SLP
- Speech-Language Pathologist
- Ponte Vedra Beach, FL
National Provider Identifier
1821736737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SZ10615
- Practice address
- 5150 Palm Valley Rd Ste 202
Ponte Vedra Beach, FL 32082-4630 - Phone
- (904) 616-3455
- NPI assigned
- May 22, 2022
- 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 | SZ10615 | FL | Primary |
Addresses
Primary practice location
5150 Palm Valley Rd Ste 202
Ponte Vedra Beach, FL 32082-4630
Mailing address
12311 Kensington Lakes Dr Unit 903
Jacksonville, FL 32246-7167
Phone (904) 651-3805
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 |
|---|---|---|---|
| SZ10615 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661212800000",
"number": "1821736737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12311 KENSINGTON LAKES DR UNIT 903",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322467167",
"telephone_number": "904-651-3805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5150 PALM VALLEY RD STE 202",
"city": "PONTE VEDRA BEACH",
"state": "FL",
"postal_code": "320824630",
"telephone_number": "904-616-3455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "ALYSSA",
"middle_name": "LEBLANC",
"credential": "CF-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-22",
"last_updated": "2022-08-23",
"certification_date": "2022-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SZ10615",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ponte Vedra Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.