Individual provider Active NPI

Bethany Zamarron

  • Speech-Language Pathologist
  • Jacksonville, FL
National Provider Identifier
1952028862
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
12025 San Jose Blvd Ste 101
Jacksonville, FL 32223-1639
Phone
(904) 880-1444
NPI assigned
Oct 21, 2022
Last updated
Oct 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X NU Primary
Speech-Language Pathologist 235Z00000X SZ11004 FL

Addresses

Primary practice location

12025 San Jose Blvd Ste 101
Jacksonville, FL 32223-1639

Mailing address

1810 Bertha St Apt 345
Jacksonville, FL 32207-3697
Phone (850) 591-1332

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

State licenses

LicenseStateTypeSpecialty
SZ11004FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Therapy Associates, LLC Speech-Language Pathologist PastSince Oct 23, 2022 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1666310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1952028862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 BERTHA ST APT 345",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073697",
            "telephone_number": "850-591-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12025 SAN JOSE BLVD STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322231639",
            "telephone_number": "904-880-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAMARRON",
        "first_name": "BETHANY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-21",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ11004",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.