Active NPI
Nicole Renee Sedan, M.S., CCC-SLP
- Speech-Language Pathologist
- Port Saint Lucie, FL
National Provider Identifier
1831377027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SZ4418
- Practice address
- 4017 SW Kamsler St
Port Saint Lucie, FL 34953-3018 - Phone
- (772) 579-0018
- NPI assigned
- Feb 10, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SZ4418 | FL | Primary |
Addresses
Primary practice location
4017 SW Kamsler St
Port Saint Lucie, FL 34953-3018
Mailing address
4017 SW Kamsler St
Port Saint Lucie, FL 34953-3018
Phone (772) 579-0018
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SZ4418 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330646400000",
"number": "1831377027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4017 SW KAMSLER ST",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349533018",
"telephone_number": "772-579-0018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4017 SW KAMSLER ST",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349533018",
"telephone_number": "772-579-0018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEDAN",
"first_name": "NICOLE",
"middle_name": "RENEE",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-10",
"last_updated": "2012-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SZ4418",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Saint Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.