Individual provider Active NPI

Tonya Lorene Carson, MS, CCC-SLP

  • Speech-Language Pathologist
  • Winter Garden, FL
National Provider Identifier
1679619563
Registry record updated May 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA6961 Issued in FL
Practice address
886 South Dillard St.
Winter Garden, FL 34787-3910
Phone
(407) 905-8958
Fax
(407) 905-8958
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2016

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 SA6961 FL Primary

Addresses

Primary practice location

886 South Dillard St.
Winter Garden, FL 34787-3910

Mailing address

12812 Keddlestone Lane
Winter Garden, FL 34787
Phone (407) 491-3825

Other identifiers 1

IdentifierTypeStateIssuer
8883866MedicaidFL

Other names 1

  • Tonya Carson Patrick Former name

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
SA6961FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tonya L. Carson, Inc. Speech-Language Pathologist CurrentSince Aug 4, 2024 Accepting new patients
Pediatric Therapy Services of Greater Orlando, LLC Speech-Language Pathologist PastSince Oct 1, 2023 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464307200000",
    "number": "1679619563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12812 KEDDLESTONE LANE",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "34787",
            "telephone_number": "407-491-3825",
            "fax_number": "407-905-8958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "886 SOUTH DILLARD ST.",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873910",
            "telephone_number": "407-905-8958",
            "fax_number": "407-905-8958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON",
        "first_name": "TONYA",
        "middle_name": "LORENE",
        "name_prefix": "Mrs.",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2016-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA6961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8883866",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TONYA",
            "last_name": "PATRICK",
            "middle_name": "CARSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winter Garden, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2016; 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.