Carrollwood Speech and Swallowing Therapy, PLLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

CARROLLWOOD SPEECH AND SWALLOWING THERAPY, PLLC

Doing business as

Carrollwood Speech & Swallowing Therapy
Carrollwood Speech and Swallowing Therapy

Practice address

14502 N Dale Mabry Hwy Ste 200
Tampa, FL 33618-2040

Phone

(813) 812-4463

NPI assigned

Dec 19, 2017

Organization subpart

No

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

Authorized official

Name

Timothy Stockdale, MS, CCC-SLP

Title

Owner

Phone

(813) 812-4463

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 2

• Carrollwood Speech & Swallowing Therapy Doing business as
• Carrollwood Speech and Swallowing Therapy Doing business as

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

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1366958977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14502 N DALE MABRY HWY STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14502 N DALE MABRY HWY STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182040",
            "telephone_number": "813-812-4463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARROLLWOOD SPEECH AND SWALLOWING THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-19",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "STOCKDALE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-812-4463",
        "authorized_official_credential": "MS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4TM44",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018980200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carrollwood Speech & Swallowing Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Carrollwood Speech and Swallowing Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Carrollwood Speech and Swallowing Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carrollwood Family Medical and Rehabilitation Center, Inc.
• Carrollwood Massage Therapy
• Carrollwood Medical Group, LLC.
• Carrollwood Operations, LLC
• Carrollwood Rehabilitation Center LLC
• Carrollwood Surgical Associates
• Carrollwood Village Counseling Associates
• Carrollwood Vision Corporation
• Catherine E Carruthers, M.D.
• Kadir Justin Carruthers, M.D.

• Speech-Language Pathologist in Tampa, FL
• Providers in Tampa, FL by specialty
• Speech-Language Pathologist in Florida

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