Individual provider Active NPI

Steffanie Andrea Wandall

  • Developmental Therapist
  • Tampa, FL
National Provider Identifier
1295016574
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
6508 Gunn Hwy
Tampa, FL 33625-4022
Phone
(813) 963-6923
NPI assigned
Aug 31, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X Primary

Addresses

Primary practice location

6508 Gunn Hwy
Tampa, FL 33625-4022

Mailing address

6508 Gunn Hwy
Tampa, FL 33625-4022
Phone (813) 963-6923

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

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Living Inc. Developmental Therapist Past Accepting new patients
Independent Living Inc. PastSince Nov 26, 2023 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": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314748800000",
    "number": "1295016574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6508 GUNN HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336254022",
            "telephone_number": "813-963-6923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6508 GUNN HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336254022",
            "telephone_number": "813-963-6923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANDALL",
        "first_name": "STEFFANIE",
        "middle_name": "ANDREA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-31",
        "last_updated": "2011-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; 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.