Individual provider Active NPI

Tetina Stillo Kinney, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Madeira Beach, FL
National Provider Identifier
1942621578
Registry record updated Dec 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA4947 Issued in FL
Practice address
150 131St Ave E
Madeira Beach, FL 33708-2622
Phone
(727) 394-1310
NPI assigned
Dec 28, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2013

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 SA4947 FL Primary

Addresses

Primary practice location

150 131St Ave E
Madeira Beach, FL 33708-2622

Mailing address

150 131St Ave E
Madeira Beach, FL 33708-2622

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
SA4947FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1388188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388188800000",
    "number": "1942621578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 131ST AVE E",
            "city": "MADEIRA BEACH",
            "state": "FL",
            "postal_code": "337082622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 131ST AVE E",
            "city": "MADEIRA BEACH",
            "state": "FL",
            "postal_code": "337082622",
            "telephone_number": "727-394-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNEY",
        "first_name": "TETINA",
        "middle_name": "STILLO",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-28",
        "last_updated": "2013-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA4947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madeira Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2013; 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.