Active NPI
Neyda Ketchum, M.ED.,C.C.C.
- Speech-Language Pathologist
- Miami, FL
National Provider Identifier
1982739389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA 4033
- Practice address
- 10725 SW 104TH St
Miami, FL 33176-8162 - Phone
- (305) 274-7883
- Fax
- (305) 274-4271
- NPI assigned
- Feb 23, 2007
- Sex
- Female
- 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 | SA 4033 | FL | Primary |
Addresses
Primary practice location
10725 SW 104TH St
Miami, FL 33176-8162
Mailing address
10110 SW 108TH St
Miami, FL 33176-3529
Phone (305) 274-5403
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA 4033 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982739389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10110 SW 108TH ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331763529",
"telephone_number": "305-274-5403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10725 SW 104TH ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331768162",
"telephone_number": "305-274-7883",
"fax_number": "305-274-4271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KETCHUM",
"first_name": "NEYDA",
"name_prefix": "Mrs.",
"credential": "M.ED.,C.C.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA 4033",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.