Individual provider Active NPI

Kendra Steward, MHS CCC-SLP

  • Speech-Language Pathologist
  • North Port, FL
National Provider Identifier
1427464767
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 14599 Issued in FL
Practice address
3680 Channing Ave
North Port, FL 34287-5163
Phone
(630) 761-0900
Fax
(630) 761-0909
NPI assigned
Jul 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 242.003101 IL
Speech-Language Pathologist 235Z00000X SA 14599 FL Primary

Addresses

Primary practice location

3680 Channing Ave
North Port, FL 34287-5163

Mailing address

3680 Channing Ave
North Port, FL 34287-5163
Phone (815) 378-0405

Other identifiers 1

IdentifierTypeStateIssuer
110677900MedicaidFL

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 14599FLMDSpeech-Language Pathologist
242.003101ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Care LTD Speech-Language Pathologist Past Accepting new patients
Therapy Care LTD Speech-Language Pathologist 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": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1427464767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3680 CHANNING AVE",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342875163",
            "telephone_number": "815-378-0405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 CHANNING AVE",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342875163",
            "telephone_number": "630-761-0900",
            "fax_number": "630-761-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWARD",
        "first_name": "KENDRA",
        "credential": "MHS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-08",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242.003101",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 14599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110677900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Port, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.