Alexandra Van Dyke

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SZ10823 Issued in FL

Practice address

4100 S Ferdon Blvd Ste A1
Crestview, FL 32536-5287

Phone

(850) 682-8388

NPI assigned

Mar 16, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Kids Talk Place, LLC Dba Pediatric Therapy Center

  • Hearing and Speech Clinic/Center
  • Crestview, FL
  • NPI 1821798786
  NPD
• Kids Talk Place LLC

  • Clinic/Center
  • Crestview, FL
  • NPI 1932861234
  NPD (past)

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

{
    "created_epoch": "1678924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1881395754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 BISCAYNE BLVD",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325662925",
            "telephone_number": "850-781-4334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 S FERDON BLVD STE A1",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325365287",
            "telephone_number": "850-682-8388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DYKE",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-16",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ10823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leilani Urap Cook
• Jacob Urda, D.O
• Jared Ure, DMD
• Jessica Carolina Urena
• Tamika D Ussery-Freeman, MD
• Jennifer Lanier Van Vrancken, D.P.T.
• Sydney Vandaele
• Lauren Vanslee, DPT
• Virgil Vargas, MSN, APRN, FNP-C
• Richard Veale, L.M.T.

• Speech-Language Pathologist in Crestview, FL
• Providers in Crestview, 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 Mar 16, 2023; 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.