Tyisha Kenshawna St. Surin

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

2011 S 25TH St Ste 108
Fort Pierce, FL 34947-4795

Phone

(561) 777-5156

NPI assigned

Oct 30, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1972147171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1168 SW COLEMAN AVE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349531823",
            "telephone_number": "561-777-5156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 S 25TH ST STE 108",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349474795",
            "telephone_number": "561-777-5156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. SURIN",
        "first_name": "TYISHA",
        "middle_name": "KENSHAWNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Lucie County Health Access Network, Inc. Dba/ Hands
• St. Lucie Injury and Health, LLC
• St. Lucie Injury Center Inc.
• St. Lucie Surgical Center, P.a.
• St. Mary and St. Anthony LLC
• Hristos Stamatopoulos, PA-C
• Tasha Andrea Stanford
• Claudia Marie Stangl, DMD
• William J Stanton, MD
• Starchanger Studios LLC Dba Starchanger Kids

• Case Manager/Care Coordinator in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Case Manager/Care Coordinator in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.