Individual provider Active NPI

Christina Lynn Haislip, M.S., CCC-SLP

  • Speech-Language Pathologist
  • St Augustine, FL
National Provider Identifier
1669510103
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA2577 Issued in FL
Practice address
717 E American Eagle Dr
St Augustine, FL 32092-5077
Phone
(904) 230-1700
Fax
(904) 230-1700
NPI assigned
Feb 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 SA2577 FL Primary

Addresses

Primary practice location

717 E American Eagle Dr
St Augustine, FL 32092-5077

Mailing address

2220 County Road 210 W
Suite 108 Box #235
Jacksonville, FL 32259-4058

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
SA2577FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1170547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669510103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 COUNTY ROAD 210 W",
            "address_2": "SUITE 108 BOX #235",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322594058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 E AMERICAN EAGLE DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320925077",
            "telephone_number": "904-230-1700",
            "fax_number": "904-230-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAISLIP",
        "first_name": "CHRISTINA",
        "middle_name": "LYNN",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA2577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.