Individual provider Active NPI

Janette Stines, M.A. CCC-SLP

  • Speech-Language Pathologist
  • Tampa, FL
National Provider Identifier
1801018551
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 1327 Issued in FL
Practice address
4209 E Temple Heights Rd
Tampa, FL 33617-4460
Phone
(813) 985-5245
Fax
(813) 980-2435
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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 SA 1327 FL Primary

Addresses

Primary practice location

4209 E Temple Heights Rd
Tampa, FL 33617-4460

Mailing address

4209 E Temple Heights Rd
Tampa, FL 33617-4460
Phone (813) 985-5245

Other identifiers 2

IdentifierTypeStateIssuer
880666700MedicaidFL
677664796MedicaidFL

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
SA 1327FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1801018551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4209 E TEMPLE HEIGHTS RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336174460",
            "telephone_number": "813-985-5245",
            "fax_number": "813-980-2435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4209 E TEMPLE HEIGHTS RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336174460",
            "telephone_number": "813-985-5245",
            "fax_number": "813-980-2435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINES",
        "first_name": "JANETTE",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 1327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "880666700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "677664796",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; 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.