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Deactivated NPI 1528310109 Deactivated / Inactive NPI Female Practitioner

Jill A Wickham , SLP-CCC

Speech-Language Pathologist • St Augustine, FL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jill Wickham has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 08, 2012
NPI Deactivation Date July 16, 2026
Total Practice Duration ~14 Years of Practice (2012 – 2026)

Professional Overview & Biography Verified Profile Summary

Jill Wickham, SLP-CCC was a registered Speech-Language Pathologist practicing in St Augustine, FL. Throughout an active medical career spanning 14 years, Jill Wickham provided care at the practice location at 1999 OLD MOULTRIE RD until profile deactivation on 2026-07-16.

Practice Location & Contact Primary Location

Practice Address

1999 Old Moultrie Rd

St Augustine, FL 320865164

Telephone 9048243311
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in St Augustine, FL

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

Practicing in St Augustine, 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

Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License FL SA8304

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

2 Associated Practitioners
Kathy Schmidt , COTA, L

Occupational Therapy Assistant

NPI 1679730840

Certified Occupational Therapy Assistant, L

Melissa Baynes

Physical Therapist

NPI 1871126516

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated July 16, 2026

Record deactivated on July 16, 2026

NPI Profile Active October 08, 2012

NPI status registered as active in NPPES database

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Updated Practice Location October 08, 2012

Registered at 1999 OLD MOULTRIE RD, ST AUGUSTINE, FL 320865164 (Tel: 9048243311)

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Updated Business Mailing Address October 08, 2012

Registered at PO BOX 734, DEFUNIAK SPGS, FL 324350734 (Tel: 8502250538)

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Provider Name / Credentials Updated October 08, 2012

Recorded as JILL WICKHAM, SLP-CCC

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 08, 2012

Speech-Language Pathologist (License #SA8304 in FL)

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Initial NPI Registration & Enumeration October 08, 2012

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: 1528310109
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 08, 2012
Last Update: October 08, 2012
Deactivation Date: July 16, 2026

Mailing Address

Po Box 734

Defuniak Spgs, FL 324350734

Phone: 8502250538

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

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