Individual provider Active NPI

Anna Claire Burks, MS CCC-SLP

  • Speech-Language Pathologist
  • Brandon, FL
National Provider Identifier
1780254375
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA20602 Issued in FL
Practice address
602 Vonderburg Dr Ste 200
Brandon, FL 33511-5900
Phone
(813) 653-1149
NPI assigned
Jun 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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 SA20602 FL Primary

Addresses

Primary practice location

602 Vonderburg Dr Ste 200
Brandon, FL 33511-5900

Mailing address

121 Huron Ave
Tampa, FL 33606-3619
Phone (662) 266-3674

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230323000858 FL Practitioner - Qualified Speech Language Pathologist 9133593676 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SA20602FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kernaghan and Moore: Speech and Language Therapy Services, Inc. Speech-Language Pathologist CurrentSince Apr 6, 2023 Accepting new patients
Kernaghan and Moore: Speech and Language Therapy Services, Inc. Speech-Language Pathologist Past Accepting new patients

Locations

6245 State Road 54
New Prt Rchy, FL 34653
Phone (727) 376-1111

1226 Mariner Blvd
Spring Hill, FL 34609
Phone (352) 666-5550

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": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1780254375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 HURON AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063619",
            "telephone_number": "662-266-3674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 VONDERBURG DR STE 200",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115900",
            "telephone_number": "813-653-1149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKS",
        "first_name": "ANNA",
        "middle_name": "CLAIRE",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA20602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.