Individual provider Active NPI

Sandra Jenks, MSCCC/SLP

  • Speech-Language Pathologist
  • Terra Ceia, FL
National Provider Identifier
1598039786
Registry record updated Mar 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 4677 Issued in FL
Practice address
305 Horseshoe Loop Road
Terra Ceia, FL 34250
Phone
(941) 773-9116
NPI assigned
Mar 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 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 4677 FL Primary

Addresses

Primary practice location

305 Horseshoe Loop Road
Terra Ceia, FL 34250

Mailing address

PO Box 40
Terra Ceia, FL 34250-0040

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 4677FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330992000000",
    "number": "1598039786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "TERRA CEIA",
            "state": "FL",
            "postal_code": "342500040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 HORSESHOE LOOP ROAD",
            "city": "TERRA CEIA",
            "state": "FL",
            "postal_code": "34250",
            "telephone_number": "941-773-9116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKS",
        "first_name": "SANDRA",
        "credential": "MSCCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-06",
        "last_updated": "2012-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 4677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terra Ceia, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.