Individual provider Active NPI

Stephanie T Booker

  • Developmental Disabilities Clinic/Center
  • Lehigh Acres, FL
National Provider Identifier
1215545199
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Practice address
1535 Scholar CT
Lehigh Acres, FL 33971-2047
Phone
(239) 308-6614
NPI assigned
Jul 16, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X Primary

Addresses

Primary practice location

1535 Scholar CT
Lehigh Acres, FL 33971-2047

Mailing address

1535 Scholar CT
Lehigh Acres, FL 33971-2047
Phone (239) 308-6614

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

NPI Registry JSON

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

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1215545199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 SCHOLAR CT",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339712047",
            "telephone_number": "239-308-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 SCHOLAR CT",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339712047",
            "telephone_number": "239-308-6614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOKER",
        "first_name": "STEPHANIE",
        "middle_name": "T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-16",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; 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.