Individual provider Active NPI

Debra Lee McPherson, CCC-SLP

  • Speech-Language Pathologist
  • Indian Harbour Beach, FL
National Provider Identifier
1962627018
Registry record updated Apr 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA3900 Issued in FL
Practice address
2040 Highway A1A Ste 203
Indian Harbour Beach, FL 32937-3566
Phone
(321) 773-8989
Fax
(321) 773-8990
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA3900 FL Primary

Addresses

Primary practice location

2040 Highway A1A Ste 203
Indian Harbour Beach, FL 32937-3566

Mailing address

420 Sheridan Ave
Satellite Beach, FL 32937-3048
Phone (321) 773-4471

Other practice location 1

240 N Wickham Rd
Suite 207
Melbourne, FL 32935-8662
Phone (321) 752-1500 ext. 1500

Other identifiers 1

IdentifierTypeStateIssuer
883361300MedicaidFL

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
SA3900FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556323200000",
    "number": "1962627018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 SHERIDAN AVE",
            "city": "SATELLITE BEACH",
            "state": "FL",
            "postal_code": "329373048",
            "telephone_number": "321-773-4471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 HIGHWAY A1A STE 203",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "329373566",
            "telephone_number": "321-773-8989",
            "fax_number": "321-773-8990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 N Wickham Rd",
            "address_2": "Suite 207",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329358662",
            "country_code": "US",
            "telephone_number": "321-752-1500 x1500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCPHERSON",
        "first_name": "DEBRA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2019-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA3900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "883361300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Harbour Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2019; 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.