Individual provider Active NPI

Taylor Sands, M.S., CCC-SLP, LSLS

  • Speech-Language Pathologist
  • Jacksonville, FL
National Provider Identifier
1568428936
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 9256 Issued in FL
Practice address
9803 Old Saint Augustine Rd
Suite 7
Jacksonville, FL 32257-8854
Phone
(904) 880-9001
Fax
(904) 880-9007
NPI assigned
Apr 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

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 9256 FL Primary

Addresses

Primary practice location

9803 Old Saint Augustine Rd
Suite 7
Jacksonville, FL 32257-8854

Mailing address

9803 Old Saint Augustine Rd
Suite 7
Jacksonville, FL 32257-8854
Phone (904) 880-9001

Other identifiers 2

IdentifierTypeStateIssuer
000770500MedicaidFL
000710600MedicaidFL

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SA 9256FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1568428936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9803 OLD SAINT AUGUSTINE RD",
            "address_2": "SUITE 7",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322578854",
            "telephone_number": "904-880-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9803 OLD SAINT AUGUSTINE RD",
            "address_2": "SUITE 7",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322578854",
            "telephone_number": "904-880-9001",
            "fax_number": "904-880-9007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDS",
        "first_name": "TAYLOR",
        "name_prefix": "Miss",
        "credential": "M.S., CCC-SLP, LSLS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 9256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000770500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000710600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; 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.