NPIMap

Individual provider Active NPI

Teresa Routh, MA-CCC/SLP

  • Speech-Language Pathologist
  • Lakeland, FL
National Provider Identifier
1275553000
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 968 Issued in FL
Practice address
1335 Ariana St
Lakeland, FL 33803-1879
Phone
(863) 413-0802
Fax
(863) 413-0812
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 SA 968 FL Primary

Addresses

Primary practice location

1335 Ariana St
Lakeland, FL 33803-1879

Mailing address

1335 Ariana St
Lakeland, FL 33803-1879
Phone (863) 413-0802

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
SA 968FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Therapy Providers, Inc. Speech-Language Pathologist Past Accepting new patients
Lakeland Therapy Providers, Inc Past Accepting new patients

Organizations & group practices 2

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1275553000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 ARIANA ST",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338031879",
            "telephone_number": "863-413-0802",
            "fax_number": "863-413-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 ARIANA ST",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338031879",
            "telephone_number": "863-413-0802",
            "fax_number": "863-413-0812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUTH",
        "first_name": "TERESA",
        "credential": "MA-CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.