NPIMap

Organization Active NPI

Excellerated Teaching Center

  • Clinic/Center
  • St Petersburg, FL
National Provider Identifier
1669040366
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
EXCELLERATED TEACHING CENTER
Practice address
5175 45TH St N
St Petersburg, FL 33714-2266
Phone
(727) 748-4060
Fax
(727) 748-4060
NPI assigned
Jun 17, 2021
Last updated
Jun 17, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
EXCELLERATED TEACHING CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Authorized official

Name
Robert Jones HasbrouckNPI 1245543867
Title
Owner
Phone
(727) 748-4060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

5175 45TH St N
St Petersburg, FL 33714-2266

Mailing address

5175 45TH St N
St Petersburg, FL 33714-2266
Phone (727) 748-4060

National Provider Directory

National Provider Directory
Tax ID family
Excellerated Teaching Center3 organizations share this tax ID, including this one
Part of
Excellerated Teaching Center

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5175 45th St N
St Petersburg, FL 33714
Phone (727) 748-4060

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623888000000",
    "number": "1669040366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5175 45TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337142266",
            "telephone_number": "727-748-4060",
            "fax_number": "727-748-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5175 45TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337142266",
            "telephone_number": "727-748-4060",
            "fax_number": "727-748-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELLERATED TEACHING CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EXCELLERATED TEACHING CENTER",
        "enumeration_date": "2021-06-17",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A",
        "authorized_official_last_name": "HASBROUCK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JONES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-748-4060"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.