Individual provider Active NPI

Tiffany Joy Banas, M.A. SLP

  • Speech-Language Pathologist
  • Lake Mary, FL
National Provider Identifier
1992076954
Registry record updated Jan 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SZ5465 Issued in FL
Practice address
710 N Sun Dr
Lake Mary, FL 32746-2507
Phone
(407) 805-3131
NPI assigned
Jan 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2012

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 SZ5465 FL Primary

Addresses

Primary practice location

710 N Sun Dr
Lake Mary, FL 32746-2507

Mailing address

1166 Island Shore LN
Apt 248
Heathrow, FL 32746-7200
Phone (724) 651-1229

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
SZ5465FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327276800000",
    "number": "1992076954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1166 ISLAND SHORE LN",
            "address_2": "APT 248",
            "city": "HEATHROW",
            "state": "FL",
            "postal_code": "327467200",
            "telephone_number": "724-651-1229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 N SUN DR",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462507",
            "telephone_number": "407-805-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANAS",
        "first_name": "TIFFANY",
        "middle_name": "JOY",
        "credential": "M.A. SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-23",
        "last_updated": "2012-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ5465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; 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.