Active NPI
Teagan Je T'Aime Wittmann
- Speech-Language Pathologist
- Eustis, FL
National Provider Identifier
1538944822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 6552
- Practice address
- 6 N Eustis St
Eustis, FL 32726-3408 - Phone
- (321) 276-5054
- NPI assigned
- Aug 28, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 6552 | FL | Primary |
Addresses
Primary practice location
6 N Eustis St
Eustis, FL 32726-3408
Mailing address
5151 Loma Vista Cir Apt 201
Oviedo, FL 32765-6674
Phone (920) 858-9645
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6552 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693180800000",
"number": "1538944822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5151 LOMA VISTA CIR APT 201",
"city": "OVIEDO",
"state": "FL",
"postal_code": "327656674",
"telephone_number": "920-858-9645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 N EUSTIS ST",
"city": "EUSTIS",
"state": "FL",
"postal_code": "327263408",
"telephone_number": "321-276-5054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITTMANN",
"first_name": "TEAGAN",
"middle_name": "JE T'AIME",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-28",
"last_updated": "2023-08-28",
"certification_date": "2023-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "6552",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eustis, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.