Active NPI
Susan R Snover, ED D CCC SLP
- Speech-Language Pathologist
- Lakeland, FL
National Provider Identifier
1992737365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA111
- Practice address
- 710 E Bella Vista St
Lakeland, FL 33805 - Phone
- (863) 686-3189
- Fax
- (863) 682-1348
- NPI assigned
- Jul 7, 2006
- 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 | SA111 | FL | Primary |
Addresses
Primary practice location
710 E Bella Vista St
Lakeland, FL 33805
Mailing address
710 E Bella Vista St
Lakeland, FL 33805
Phone (863) 686-3189
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 115192 | Other | FL | AMERIGROUP |
| S2936 | Other | FL | BLUE CROSS BLUE SHIELD |
| 11982101 | Other | FL | CITRUS HEALTHCARE |
| 244 | Other | FL | ATA |
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 |
|---|---|---|---|
| SA111 | FL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Florida Speech & Hearing Center | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Speech-Language Pathologist
- Lakeland, FL
- NPI 1336171826
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992737365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 E BELLA VISTA ST",
"city": "LAKELAND",
"state": "FL",
"postal_code": "33805",
"telephone_number": "863-686-3189",
"fax_number": "863-682-1348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 E BELLA VISTA ST",
"city": "LAKELAND",
"state": "FL",
"postal_code": "33805",
"telephone_number": "863-686-3189",
"fax_number": "863-682-1348"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SNOVER",
"first_name": "SUSAN",
"middle_name": "R",
"name_prefix": "Ms.",
"credential": "ED D CCC SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA111",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "115192",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "S2936",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CITRUS HEALTHCARE",
"identifier": "11982101",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ATA",
"identifier": "244",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, 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.