Individual provider Active NPI

Teranya Shaye Boykins, MS, CCC-SLP

  • Speech-Language Pathologist
  • Brandon, FL
National Provider Identifier
1487870549
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA7686 Issued in FL
Practice address
602 Vonderburg Dr
Suite 201
Brandon, FL 33511-5900
Phone
(863) 617-9400
Fax
(863) 688-9858
NPI assigned
Apr 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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 SA7686 FL Primary

Addresses

Primary practice location

602 Vonderburg Dr
Suite 201
Brandon, FL 33511-5900

Mailing address

122 E Main St # 304
Lakeland, FL 33801-4655
Phone (863) 732-9955

Other identifiers 2

IdentifierTypeStateIssuer
109131600MedicaidFL
891535100MedicaidFL

Other names 1

  • Mrs. Teranya Shaye Johnson Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150714000937 FL Practitioner - Qualified Speech Language Pathologist 7719290196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virtually Speaking, LLCGroup PAC ID 9830590108, 2 clinicians

Practice addresses (Care Compare)

1849 N Crystal Lake Dr
Lakeland, FL 33801-5902
Phone (863) 732-9955

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
The Caring Group- Caring, Uplifting, Serving, LLC Current Accepting new patients
Virtually Speaking, LLC Speech-Language Pathologist CurrentSince May 31, 2021 Accepting new patients

Locations

1849 N Crystal Lake Dr
Lakeland, FL 33801
Phone (863) 732-9955

5130 S Florida Ave
Ste 411
Lakeland, FL 33813
Phone (725) 300-0603

122 E Main St
#304
Lakeland, FL 33801

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": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1487870549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 E MAIN ST # 304",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338014655",
            "telephone_number": "863-732-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 VONDERBURG DR",
            "address_2": "SUITE 201",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115900",
            "telephone_number": "863-617-9400",
            "fax_number": "863-688-9858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYKINS",
        "first_name": "TERANYA",
        "middle_name": "SHAYE",
        "name_prefix": "Mrs.",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA7686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109131600",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891535100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERANYA",
            "last_name": "JOHNSON",
            "middle_name": "SHAYE",
            "prefix": "MRS.",
            "credential": "MS, CCC-SLP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.