Individual provider Active NPI

Courtney Welch

  • Speech-Language Pathologist
  • North Port, FL
National Provider Identifier
1962913202
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA15795 Issued in FL
Practice address
2186 Pennsylvania Ter
North Port, FL 34291-6292
Phone
(941) 202-3182
NPI assigned
Oct 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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 SA15795 FL Primary

Addresses

Primary practice location

2186 Pennsylvania Ter
North Port, FL 34291-6292

Mailing address

2186 Pennsylvania Ter
North Port, FL 34291-6292
Phone (813) 562-3731

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240304003580 FL Practitioner - Qualified Speech Language Pathologist 1153766829 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1101 Tamiami TRL S
Suite 209D
Venice, FL 34285-4133
Phone (941) 202-3182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SA15795FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince Mar 11, 2024 Accepting new patients
Champion Speech Therapy LLC Speech-Language Pathologist CurrentSince Feb 26, 2024 Accepting new patients
Legacy Healthcare Services, Inc Speech-Language Pathologist CurrentSince Mar 11, 2024 Accepting new patients

Locations

2219 Chiquita Blvd S
Cape Coral, FL 33991
Phone (239) 205-3654

8213 Killearn Lakes Ter
Tallahassee, FL 32312
Phone (850) 391-0979

1101 Tamiami Trl S
Ste 209D
Venice, FL 34285
Phone (941) 202-3182

38130 Pretty Pond Rd
Zephyrhills, FL 33540
Phone (813) 400-2291

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

Networks

  • Optimum HealthCare HMO Network

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1507852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1962913202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2186 PENNSYLVANIA TER",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342916292",
            "telephone_number": "813-562-3731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2186 PENNSYLVANIA TER",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342916292",
            "telephone_number": "941-202-3182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCH",
        "first_name": "COURTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-13",
        "last_updated": "2024-02-15",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA15795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Port, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.