Individual provider Active NPI

Brianna Coltellino

  • Speech-Language Pathologist
  • St Augustine, FL
National Provider Identifier
1871211375
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SZ10838 Issued in FL
Practice address
56 Water St
St Augustine, FL 32084-2887
Phone
(727) 364-4024
NPI assigned
Aug 19, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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 SZ10838 FL Primary

Addresses

Primary practice location

56 Water St
St Augustine, FL 32084-2887

Mailing address

56 Water St
St Augustine, FL 32084-2887
Phone (727) 364-4024

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260522000966 FL Practitioner - Qualified Speech Language Pathologist 4183194863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

195 Nellie Woods LN
Apt 102
Oviedo, FL 32765-4758

195 Nellie Woods LN Apt
Suite 102
Oviedo, FL 32765-4758

3280 Progress Dr
Suite 500
Orlando, FL 32826-2903

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SZ10838FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Talk of the Town Speech Therapy LLC Speech-Language Pathologist CurrentSince Aug 28, 2022 Accepting new patients
Talk of the Town Speech Therapy LLC PastSince Aug 28, 2022 Accepting new patients

Organizations & group practices 3

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": "1660867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1871211375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 WATER ST",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320842887",
            "telephone_number": "727-364-4024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 WATER ST",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320842887",
            "telephone_number": "727-364-4024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLTELLINO",
        "first_name": "BRIANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-19",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ10838",
            "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 Aug 19, 2022; 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.