NPIMap

Organization Active NPI

JMB Speech Language and Pathology Services, Inc

  • Speech-Language Pathologist
  • Tampa, FL
National Provider Identifier
1942419775
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA1577 Issued in FL
Legal business name
JMB SPEECH LANGUAGE AND PATHOLOGY SERVICES, INC
Practice address
3902 W Hamilton Ave Ste 3
Tampa, FL 33614
Phone
(813) 930-0197
Fax
(818) 930-0197
NPI assigned
May 21, 2007
Organization subpart
Yes
Parent organization
JMB SPEECH LANGUAGE AND PATHOLOGY SERVICES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Everett Ivan Nicely
Title
Business MGR.
Phone
(813) 930-0197

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X SA1577 FL Primary

Addresses

Primary practice location

3902 W Hamilton Ave Ste 3
Tampa, FL 33614

Mailing address

3902 W Hamilton Ave Ste 3
Tampa, FL 33614
Phone (813) 930-0197

Other identifiers 2

IdentifierTypeStateIssuer
686948396MedicaidFL
880866000MedicaidFL

Other names 1

  • Jeanne M. Barth Speech Therapy Former legal business name

National Provider Directory

National Provider Directory
Part of
JMB Speech Language and Pathology Services Inc

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622678400000",
    "number": "1942419775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3902 W HAMILTON AVE STE 3",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33614",
            "telephone_number": "813-930-0197",
            "fax_number": "813-930-2426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3902 W HAMILTON AVE STE 3",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33614",
            "telephone_number": "813-930-0197",
            "fax_number": "818-930-0197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JMB SPEECH LANGUAGE AND PATHOLOGY SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JMB SPEECH LANGUAGE AND PATHOLOGY SERVICES, INC",
        "enumeration_date": "2007-05-21",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A",
        "authorized_official_last_name": "NICELY",
        "authorized_official_first_name": "EVERETT",
        "authorized_official_middle_name": "IVAN",
        "authorized_official_title_or_position": "BUSINESS MGR.",
        "authorized_official_telephone_number": "813-930-0197",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA1577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "686948396",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "880866000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jeanne M. Barth Speech Therapy",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Jeanne M. Barth Speech Therapy",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Jun 3, 2021; 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.