Individual provider Active NPI

Lisa Larkin Winsbro

  • Speech-Language Pathologist
  • St Petersburg, FL
National Provider Identifier
1417073966
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 6676 Issued in FL
Practice address
500 7TH Ave S
St Petersburg, FL 33701-4820
Phone
(727) 767-6741
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 6676 FL Primary

Addresses

Primary practice location

500 7TH Ave S
St Petersburg, FL 33701-4820

Mailing address

11201 Blacksmith Dr
Tampa, FL 33626-2675
Phone (813) 854-3439

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 6676FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417073966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11201 BLACKSMITH DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336262675",
            "telephone_number": "813-854-3439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 7TH AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014820",
            "telephone_number": "727-767-6741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINSBRO",
        "first_name": "LISA",
        "middle_name": "LARKIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 6676",
            "primary": true
        }
    ],
    "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 Jul 8, 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.