Tevin Minus, ST

Individual provider Active NPI Speech-Language Pathologist · Jay, FL

NPI 1083369813 · NPPES record last updated Feb 21, 2022

Key facts

NPI
1083369813
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SZ10565
Practice address
3964 Florida Ave
Jay, FL 32565-1104
Phone
(850) 675-4000
NPI assigned
Feb 21, 2022
Sex
Male
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Qualified Speech Language Pathologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Action Therapy Group LLC (69 clinicians)

Practice addresses (Care Compare)

3964 Florida Ave
Jay, FL 32565-1104
Phone (850) 741-6715

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20221221000695 FL Practitioner - Qualified Speech Language Pathologist 9133599848 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Action Therapy Group LLC Current
since Dec 1, 2022
Accepting new patients

Locations

3964 Florida Ave
Jay, FL 32565
Phone (850) 675-4000

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SZ10565 Yes

Addresses

Primary practice location

3964 Florida Ave
Jay, FL 32565-1104

Mailing address

3331 Summit Blvd Apt 172
Pensacola, FL 32503-4331
Phone (850) 741-6715

Other providers in Jay, FL

All providers in Jay, FL · Speech-Language Pathologist in Florida

Sources for this page

Verify at the official NPI Registry.