Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1346760170 Individual Practitioner Female Practitioner

Krista Waggoner , CCC-SLP

Speech-Language Pathologist • Palm Coast, FL

Professional Overview & Biography Verified Profile Summary

Krista Waggoner, CCC-SLP is a registered healthcare professional specializing in Speech-Language Pathologist in Palm Coast, FL. Practice services are available at 4875 PALM COAST PKWY NW UNIT 2 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4875 Palm Coast Pkwy Nw Unit 2

Palm Coast, FL 321373671

Telephone 3864469935
Fax 3864467777
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Palm Coast, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 15.5 Yrs
State Avg: 16.7 Yrs
Regional Practice Density
63 Specialists

Practicing in Palm Coast, FL (11640 Statewide)

Telehealth Adoption Rate
0.0% 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

CMS Verified: 2022-02-21
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License FL SA16585

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.

Speech-Language Pathologist

NUCC Taxonomy Code: 235Z00000X

State License TX 117777

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.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Florida Healthcare Practioner License
SA16585 (FL)
Commercial Insurance / Payer ID Florida Healthcare Practioner License
SZ8087 (FL)
Commercial Insurance / Payer ID Texas Speech-Language Pathologist License
117777 (TX)

Secondary Practice Locations

112 Braves Way

Lavon, TX 751664700

Phone: 7346204533

Practice Associates & Co-Workers

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

40 Associated Practitioners
Dr. Bridget Jones , OTD OTR, L

Occupational Therapist

NPI 1053041814

OTDOTR, L

NPI 1083955033

Physical Therapist, Doctor of Physical Therapy

Tresa Scotch , MS, CCC-SLP

Speech-Language Pathologist

NPI 1093957243

Master of Science, Speech-Language Pathologist (Certificate of Clinical Competence)

Jade Newberry , SLPA

Speech-Language Pathologist

NPI 1104653583

Speech-Language Pathology Assistant

Shelly Williamson

Speech-Language Pathologist

NPI 1114496791
Desiree Trujillo

Speech-Language Pathologist

NPI 1124812813

Career & Practice History Timeline

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

10 Historical Events
📍
Updated Business Mailing Address February 21, 2022

Registered at 112 BRAVES WAY, LAVON, TX 751664700 (Tel: 7346204533)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 21, 2022

Speech-Language Pathologist (License #117777 in TX)

👤
Provider Name / Credentials Updated March 01, 2019

Recorded as KRISTA WAGGONER, CCC-SLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 01, 2019

Speech-Language Pathologist (License #SA16585 in FL)

NPI Profile Active June 22, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location June 22, 2017

Registered at 4875 PALM COAST PKWY NW UNIT 2, PALM COAST, FL 321373671 (Tel: 3864469935)

📍
Updated Business Mailing Address June 22, 2017

Registered at 212 INTEGRA SHORES DR UNIT 307, DAYTONA BEACH, FL 321175578 (Tel: 7346204533)

👤
Provider Name / Credentials Updated June 22, 2017

Recorded as KRISTA WAGGONER, CFY-SLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 22, 2017

Speech-Language Pathologist (License #SZ8087 in FL)

🟢
Initial NPI Registration & Enumeration June 22, 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: 1346760170
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 22, 2017
Last Update: February 21, 2022
Sole Proprietor: Yes

Mailing Address

112 Braves Way

Lavon, TX 751664700

Phone: 7346204533

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.