Individual provider Active NPI

T Spence, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Lake Mary, FL
National Provider Identifier
1073814968
Registry record updated Apr 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
106333 Issued in TX
Practice address
400 International Pkwy Ste 300
Lake Mary, FL 32746-5065
Phone
(800) 806-6026
NPI assigned
Nov 8, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2013

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 106333 TX Primary
Speech-Language Pathologist 235Z00000X SA 10691 FL

Addresses

Primary practice location

400 International Pkwy Ste 300
Lake Mary, FL 32746-5065

Mailing address

400 International Parkway
Suite 300
Lake Mary, FL 32746

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SA 10691FLMDSpeech-Language Pathologist
106333TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365897600000",
    "number": "1073814968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 INTERNATIONAL PARKWAY",
            "address_2": "SUITE 300",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "32746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 INTERNATIONAL PKWY STE 300",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465065",
            "telephone_number": "800-806-6026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCE",
        "first_name": "T",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-08",
        "last_updated": "2013-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "106333",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 10691",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.