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Ivonne Carmen Randolph , MACCCSLP

Speech-Language Pathologist β€’ Port Orange, FL

Active NPI 1922148451 Individual Practitioner Female Practitioner
Practice location in NPPES

5791 Falling Tree Ln
Port Orange, FL 321277993

Call 4075952710 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

5791 Falling Tree Ln

Port Orange, FL 321277993

Telephone 4075952710
Other Listings in Public Data

NPPES lists 1 additional practice-address record in Deland, FL. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2007

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Port Orange and Florida

101 active clinicians are listed under Speech-Language Pathologist with a practice address in Port Orange, FL (11,513 in Florida).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Port Orange

1% of these 101 clinicians have the CMS telehealth indicator.

5.9% of these 101 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-02-16
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

License # reported to NPPES FL SA 1206

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.

Developmental Therapist

NUCC Taxonomy Code: 222Q00000X

A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development.

Early Intervention Provider Agency

NUCC Taxonomy Code: 252Y00000X

Early intervention services are an effective way to address the needs of infants and toddlers who have developmental delays or disabilities. The services are made available through a federal law known as the Individuals with Disabilities Education Act (IDEA). IDEA provides states and territories with specific requirements for providing early intervention services to infants and toddlers with special needs. In turn, each state and territory develops its own policies for carrying out IDEA and its requirements. Broadly speaking, early intervention services are special services for eligible infants and toddlers and their families. These services are designed to identify and meet children's needs in five developmental areas. These areas are: physical development, cognitive development, communication, social or emotional development, and adaptive development.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Florida Department of Health Medical Quality Assurance.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
884535200 (FL)

Secondary Practice Locations

2219 S Woodland Blvd

Deland, FL 327208628

Phone: 3867369849

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 16, 2025

Developmental Therapist

πŸ“
Updated Practice Location October 15, 2020

Registered at 5791 FALLING TREE LN, PORT ORANGE, FL 321277993 (Tel: 4075952710)

πŸ“
Updated Business Mailing Address October 15, 2020

Registered at 5791 FALLING TREE LN, PORT ORANGE, FL 321277993 (Tel: 4075952710)

βœ…
NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) July 09, 2007

Registered at 2219 S WOODLAND BLVD, DELAND, FL 327208628 (Tel: 3867369849)

πŸ“
Business Mailing Address (Initial Record) July 09, 2007

Registered at 30135 BLUEBELL AVE W, EUSTIS, FL 32736 (Tel: 3523570316)

πŸ‘€
Provider Name / Credentials (Initial Record) July 09, 2007

Recorded as IVONNE RANDOLPH, MACCCSLP

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Speech-Language Pathologist (license number reported to NPPES: FL SA 1206)

🟒
Initial NPI Registration & Enumeration February 07, 2007

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1922148451
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 07, 2007
Last Update: February 16, 2025
Sole Proprietor: Yes

Other Speech-Language Pathologists in Port Orange

Healthcare providers in Port Orange

Mailing Address

5791 Falling Tree Ln

Port Orange, FL 321277993

Phone: 4075952710

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.