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Active NPI 1255872024 Individual Practitioner Female Practitioner

Kellam Black , SLP

Speech-Language Pathologist • Jacksonville, FL

Professional Overview & Biography Verified Profile Summary

Kellam Black, SLP is a registered healthcare professional specializing in Speech-Language Pathologist in Jacksonville, FL. Practice services are available at 14550 OLD SAINT AUGUSTINE RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

14550 Old Saint Augustine Rd

Jacksonville, FL 322582460

Telephone 9042716575
Associated Practice Facility / Clinic
🏢 Emergency Physicians Inc Facility NPI 1740457522

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Jacksonville, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.8 Yrs
State Avg: 16.7 Yrs
Regional Practice Density
565 Specialists

Practicing in Jacksonville, FL (11640 Statewide)

Telehealth Adoption Rate
1.6% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License FL SA8959

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
Dr. Renee Golson , DPT

Physical Therapist

NPI 1114246485

Doctor of Physical Therapy

Dr. Paul Provenzano , DPT

Physical Therapist

NPI 1275901878

Doctor of Physical Therapy

NPI 1629624440

Physical Therapist, Doctor of Physical Therapy

Julianne Bryce

Physical Therapist

NPI 1992188825

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active March 13, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location March 13, 2017

Registered at 14550 OLD SAINT AUGUSTINE RD, JACKSONVILLE, FL 322582460 (Tel: 9042716575)

📍
Updated Business Mailing Address March 13, 2017

Registered at 126 GLEN EAGLES CT, PONTE VEDRA BEACH, FL 320823613 (Tel: 9044779351)

👤
Provider Name / Credentials Updated March 13, 2017

Recorded as KELLAM BLACK, S.L.P.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 13, 2017

Speech-Language Pathologist (License #SA8959 in FL)

🟢
Initial NPI Registration & Enumeration March 13, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1255872024
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 13, 2017
Last Update: March 13, 2017
Sole Proprietor: No

Mailing Address

126 Glen Eagles Ct

Ponte Vedra Beach, FL 320823613

Phone: 9044779351

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.