Beth R Poe, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP00723 Issued in RI

Practice address

12276 San Jose Blvd
Jacksonville, FL 32223-8628

Phone

(904) 886-3228

NPI assigned

Jul 9, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Way to Grow Therapies

  • Speech-Language Pathologist
  • Jacksonville, FL
  • NPI 1902793995
  NPD Authorized official
• Greatstridesrehabilitation

  • Community/Behavioral Health Agency
  • Jacksonville, FL
  • NPI 1033566351
  NPD (past)

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1881627982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4185 VENETIA BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322108505",
            "telephone_number": "401-864-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12276 SAN JOSE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238628",
            "telephone_number": "904-886-3228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POE",
        "first_name": "BETH",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "RI",
            "license": "SP00723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS # FOR RI HOSPITAL",
            "identifier": "26836",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS # FOR RIARC",
            "identifier": "409851",
            "state": "RI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bpoe@greatstridesrehab.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "12276 San Jose Blvd",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322238628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Podiatry Associates of Florida, Inc.
• Podvia and Stanford DMDS
• Kristan David Podvia, DMD
• Gina Poe-Stewart
• April Chrelle Poe, ARNP
• Emily Poellnitz
• Andreea Poenariu, M.D.
• Chelsea Poff, APRN
• Charlotte G. Poger, M.ED., LMHC
• Robert O. Pohl, M.D.

• Speech-Language Pathologist in Jacksonville, FL
• Providers in Jacksonville, 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 Oct 21, 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.

Verify at the official NPI Registry.