Individual provider Active NPI

Candice Patricia Sollner, CCC-SLP

  • Speech-Language Pathologist
  • Tampa, FL
National Provider Identifier
1033257563
Registry record updated Jul 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA8545 Issued in FL
Practice address
3501 Bayshore Blvd
Tampa, FL 33629-8901
Phone
(813) 837-1083
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X
Speech-Language Pathologist 235Z00000X SA8545 FL Primary

Addresses

Primary practice location

3501 Bayshore Blvd
Tampa, FL 33629-8901

Mailing address

2645 S Dundee St
Tampa, FL 33629-7539
Phone (813) 842-1166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240222001180 FL Practitioner - Qualified Speech Language Pathologist 9133563794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Momentum Rehabilitation LLCGroup PAC ID 5496115727, 5 clinicians

Practice addresses (Care Compare)

Tampa, FL 33629
Phone (813) 352-1776

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SA8545FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Momentum Rehabilitation LLC Speech-Language Pathologist CurrentSince Jan 20, 2024 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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690070400000",
    "number": "1033257563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 S DUNDEE ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336297539",
            "telephone_number": "813-842-1166",
            "fax_number": "813-842-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 BAYSHORE BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336298901",
            "telephone_number": "813-837-1083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLLNER",
        "first_name": "CANDICE",
        "middle_name": "PATRICIA",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2023-07-23",
        "certification_date": "2023-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA8545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.