Active NPI
Larry Keith Blythe, CCC-SLP
- Speech-Language Pathologist
- Fort Myers, FL
National Provider Identifier
1952879710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA14664
- Practice address
- 16351 Summerlin Rd
Fort Myers, FL 33908-5764 - Phone
- (239) 454-6130
- NPI assigned
- Nov 8, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA14664 | FL | Primary |
Addresses
Primary practice location
16351 Summerlin Rd
Fort Myers, FL 33908-5764
Mailing address
16351 Summerlin Rd
Fort Myers, FL 33908-5764
Phone (239) 454-6130
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
| License | State | Type | Specialty |
|---|---|---|---|
| SA14664 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541635200000",
"number": "1952879710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16351 SUMMERLIN RD",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339085764",
"telephone_number": "239-454-6130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16351 SUMMERLIN RD",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339085764",
"telephone_number": "239-454-6130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLYTHE",
"first_name": "LARRY",
"middle_name": "KEITH",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-08",
"last_updated": "2018-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA14664",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.