Tajshma Tagayla Peterson

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Practice address

315 NE 10TH Ave
Crystal River, FL 34429-4456

Phone

(352) 795-7006

NPI assigned

Oct 18, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Superior Therapy Services Inc

  • Clinic/Center
  • Crystal River, FL
  • NPI 1134117542

  Early Intervention Provider Agency

  NPD

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1508529488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 PLEASANT GROVE RD",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344524414",
            "telephone_number": "727-667-4993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 NE 10TH AVE",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344294456",
            "telephone_number": "352-795-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "TAJSHMA",
        "middle_name": "TAGAYLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatrix Medical Group of Florida Inc
• Danielle Elizabeth Perugini
• Debbie Ann Petellat
• John E Peterlin, DVM
• Marcie Lynn Peterson
• Cassandra Petty
• Barbara Pinkston, COTA
• Plantation Medical Care, PA
• Franz Josef Plum, M.D.
• Alexei Polk, PA-C

• Early Intervention Provider Agency in Crystal River, FL
• Providers in Crystal River, FL by specialty
• Early Intervention Provider Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; 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.