Tabitha Jean Dewolf

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

29228 US Highway 19 N
Clearwater, FL 33761-2101

Phone

(727) 351-4191

NPI assigned

Aug 10, 2016

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

• Tabitha Jean Nuttall Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 17, 2018.

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1356895072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 MIDDLE ST UNIT 1201",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29228 US HIGHWAY 19 N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337612101",
            "telephone_number": "727-351-4191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 N Reo St",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336091061",
            "country_code": "US",
            "telephone_number": "813-374-2070",
            "fax_number": "813-337-0937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "550 N Reo St",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336091061",
            "country_code": "US",
            "telephone_number": "813-374-2070",
            "fax_number": "813-337-0937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEWOLF",
        "first_name": "TABITHA",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TABITHA",
            "last_name": "NUTTALL",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Devries Family Medicine Professional Association
• Benjamin Devries, DO
• Jodi N Devries, CRNA
• Devaki V. Dewan, M. D.
• Naakesh A Dewan, M.D.
• Jessica Deys
• Dharamraj Inc
• Kenneth S Dharamraj, M.D.
• Celia P Di Marco, MD
• Joel A. Di Santi, DPM

• All providers in Clearwater, FL
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.