Krystal Nicole Green, SLPA

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SZ11217 Issued in FL

Practice address

549 NW Lake Whitney PL Ste 104
Port Saint Lucie, FL 34986-1606

Phone

(772) 301-1207

NPI assigned

Aug 3, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Nextvoice Therapy LLC

  • Speech-Language Pathologist
  • Port Saint Lucie, FL
  • NPI 1437073608
  NPD (past) Authorized official

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

{
    "created_epoch": "1533254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1992283634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 SW LEWIS ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349872079",
            "telephone_number": "772-971-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "549 NW LAKE WHITNEY PL STE 104",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349861606",
            "telephone_number": "772-301-1207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KRYSTAL",
        "middle_name": "NICOLE",
        "credential": "SLPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-03",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ11217",
            "primary": true
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "FL",
            "license": "3394",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Place Care Center Inc
• Grandparents House Alf 2 Inc
• Grandparents House Alf Inc
• Robert Lance Grayson, MS, LMT, NCTMB, EFR
• Sara Michele Greco
• Michelle Green
• Yochabelle Greene
• Dionne Leland Greenwood, COTA
• Damien Gregorian
• Grema Medical Services, LLC

• Speech-Language Pathologist in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.