Kendall Jordan Hannah

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA17867 Issued in FL

Practice address

1620 Helvenston St SE
Live Oak, FL 32064-3474

Phone

(386) 590-3411

NPI assigned

Sep 29, 2020

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

Other names 1

• Kendall Jordan Hall Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1922615277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 SW ROBINSON CT",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320244193",
            "telephone_number": "386-590-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 HELVENSTON ST SE",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "320643474",
            "telephone_number": "386-590-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNAH",
        "first_name": "KENDALL",
        "middle_name": "JORDAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-29",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA17867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENDALL",
            "last_name": "HALL",
            "middle_name": "JORDAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Speech-Language Pathologist in Live Oak, FL
• Providers in Live Oak, 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 Sep 29, 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.