Allyson Wade

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA14786 Issued in FL

Practice address

515 Chesapeake Dr
Tarpon Springs, FL 34689-2515

Phone

(727) 934-4629

NPI assigned

Sep 2, 2015

Last updated

Aug 12, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Allyson Clark Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1841667268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 COMPASS RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600268001",
            "telephone_number": "877-787-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 CHESAPEAKE DR",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346892515",
            "telephone_number": "727-934-4629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "ALLYSON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-02",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ7251",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA14786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015656900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLYSON",
            "last_name": "CLARK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeheila Rhoxanne Briones Villaflor
• Nicolas Pablo Villanustre, M.D.
• Vincent E C Kiesel MD PA
• Volunteers of America of Florida, Inc
• Georgia My Vong, CRNA
• Wal-Mart Stores East LP (Walmart Pharmacy 10-3415)
• Walgreen Co (Walgreens #06541)
• Marie Elena Walker, ARNP
• Shannon Theresa Waters-Mitchell
• Waymaker Services LLC.

• Speech-Language Pathologist in Tarpon Springs, FL
• Providers in Tarpon Springs, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; 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.