Individual provider Active NPI

Tawana Evet Maybell, RDMS,RVT

  • Sonography Radiologic Technologist
  • St Petersburg, FL
National Provider Identifier
1245695204
Registry record updated Dec 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sonography Radiologic TechnologistTaxonomy code 2471S1302X
License
118611 Issued in FL
Practice address
4905 34TH St S # 287
Saint Petersburg, FL 33711-4511
Phone
(727) 201-8692
Fax
(727) 201-8692
NPI assigned
Dec 17, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sonography Radiologic Technologist 2471S1302X 118611 FL Primary
Vascular Sonography Radiologic Technologist 2471V0105X 118611 FL

Addresses

Primary practice location

4905 34TH St S # 287
Saint Petersburg, FL 33711-4511

Mailing address

2415 Granada Cir E
Saint Petersburg, FL 33712-3917
Phone (727) 201-8692

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
118611FLMDSonography Radiologic Technologist

NPI Registry JSON

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

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450310400000",
    "number": "1245695204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 GRANADA CIR E",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337123917",
            "telephone_number": "727-201-8692",
            "fax_number": "727-201-8692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 34TH ST S # 287",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337114511",
            "telephone_number": "727-201-8692",
            "fax_number": "727-201-8692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYBELL",
        "first_name": "TAWANA",
        "middle_name": "EVET",
        "name_prefix": "Mrs.",
        "credential": "RDMS,RVT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-17",
        "last_updated": "2015-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": "FL",
            "license": "118611",
            "primary": true
        },
        {
            "code": "2471V0105X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Vascular Sonography",
            "state": "FL",
            "license": "118611",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2015; 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.