Homegrown Communication-SLP, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

HOMEGROWN COMMUNICATION-SLP, LLC

Practice address

5163 Shirley Ave
Jacksonville, FL 32210-3145

Phone

(352) 871-6882

Fax

(904) 212-0363

NPI assigned

Feb 20, 2020

Last updated

Feb 20, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Eric James Perez, M.A., CCC-SLP

Title

Owner-Member

Phone

(352) 871-6882

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582156800000",
    "number": "1922631779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5163 SHIRLEY AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322103145",
            "telephone_number": "352-871-6882",
            "fax_number": "904-212-0363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5163 SHIRLEY AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322103145",
            "telephone_number": "352-871-6882",
            "fax_number": "904-212-0363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMEGROWN COMMUNICATION-SLP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-20",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER-MEMBER",
        "authorized_official_telephone_number": "352-871-6882",
        "authorized_official_credential": "M.A., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.