Individual provider Active NPI

Donna M Poth, SLP

  • Speech-Language Pathologist
  • Lithia, FL
National Provider Identifier
1093861510
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA4830 Issued in FL
Practice address
5920 Beaconpark St
Lithia, FL 33547-5886
Phone
(813) 413-7785
Fax
(407) 386-7132
NPI assigned
Jan 26, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA4830 FL Primary

Addresses

Primary practice location

5920 Beaconpark St
Lithia, FL 33547-5886

Mailing address

3029 Beaver Pond TRL
Valrico, FL 33594-7930

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

State licenses

LicenseStateTypeSpecialty
SA4830FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Playful Interventions, Inc. Speech-Language Pathologist Past 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093861510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3029 BEAVER POND TRL",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335947930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 BEACONPARK ST",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335475886",
            "telephone_number": "813-413-7785",
            "fax_number": "407-386-7132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTH",
        "first_name": "DONNA",
        "middle_name": "M",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA4830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithia, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.