Individual provider Active NPI

Dana Simon, MS, SLP

  • Speech-Language Pathologist
  • Fort Walton Beach, FL
National Provider Identifier
1912423955
Registry record updated Aug 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SZ8687 Issued in FL
Practice address
2108 Lewis Turner Blvd
Fort Walton Beach, FL 32547-1316
Phone
(850) 862-3728
NPI assigned
Aug 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SZ8687 FL Primary
Behavior Technician 106S00000X RBT-16-17932 NM
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2108 Lewis Turner Blvd
Fort Walton Beach, FL 32547-1316

Mailing address

2108 Lewis Turner Blvd
Fort Walton Beach, FL 32547-1316

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

LicenseStateTypeSpecialty
RBT-16-17932NMMDBehavior Technician
SZ8687FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Rehabilitation Services, Inc. Speech-Language Pathologist CurrentSince Dec 15, 2019 Accepting new patients

Locations

2108 Lewis Turner Blvd
Fort Walton Beach, FL 32547
Phone (850) 862-3728

Organizations & group practices 1

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": "1503360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1912423955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 LEWIS TURNER BLVD",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 LEWIS TURNER BLVD",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471316",
            "telephone_number": "850-862-3728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "DANA",
        "credential": "MS, SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-22",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ8687",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NM",
            "license": "RBT-16-17932",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; 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.