Individual provider Active NPI

Christina Carter, EDS

  • School Psychologist
  • Riverview, FL
National Provider Identifier
1124604657
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
SS1445 Issued in FL
Practice address
10863 Boyette Rd
Riverview, FL 33569-8012
Phone
(813) 444-8760
NPI assigned
Mar 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X SS1445 FL Primary

Addresses

Primary practice location

10863 Boyette Rd
Riverview, FL 33569-8012

Mailing address

3904 W Estrella St
Tampa, FL 33629-5826
Phone (561) 352-1318

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
SS1445FLMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Lake and Associates PastSince Mar 28, 2021 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": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1124604657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3904 W ESTRELLA ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295826",
            "telephone_number": "561-352-1318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10863 BOYETTE RD",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335698012",
            "telephone_number": "813-444-8760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "CHRISTINA",
        "credential": "EDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "FL",
            "license": "SS1445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.