Individual provider Active NPI

Tracy Anne Sanchez, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Jacksonville, FL
National Provider Identifier
1770750093
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA9474 Issued in FL
Practice address
841 Prudential Dr
Suite 140
Jacksonville, FL 32207-8329
Phone
(904) 346-0394
NPI assigned
May 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

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 SA9474 FL Primary

Addresses

Primary practice location

841 Prudential Dr
Suite 140
Jacksonville, FL 32207-8329

Mailing address

1401 Riverplace Blvd Apt 2208
Jacksonville, FL 32207-1820
Phone (818) 389-0098

Other identifiers 1

IdentifierTypeStateIssuer
SA9474OtherFLSPEECH LANGUAGE PATHOLOGY LICENSE

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 Arts

State licenses

LicenseStateTypeSpecialty
SA9474FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210809600000",
    "number": "1770750093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 RIVERPLACE BLVD APT 2208",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322071820",
            "telephone_number": "818-389-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 PRUDENTIAL DR",
            "address_2": "SUITE 140",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078329",
            "telephone_number": "904-346-0394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANCHEZ",
        "first_name": "TRACY",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA9474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH LANGUAGE  PATHOLOGY LICENSE",
            "identifier": "SA9474",
            "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 May 15, 2008; 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.