Carolina Pediatric Therapy Services, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5345 Issued in SC

Legal business name

CAROLINA PEDIATRIC THERAPY SERVICES, LLC

Practice address

1000 Pine St W
Varnville, SC 29944-4750

Phone

(803) 942-0532

NPI assigned

Nov 2, 2016

Organization subpart

No

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

Authorized official

Name

Samantha Johnson, MA,CCC-SLP

Title

Owner/Speech Language Pathologist

Phone

(803) 942-0532

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478044800000",
    "number": "1003368416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 368",
            "city": "HAMPTON",
            "state": "SC",
            "postal_code": "299240368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 PINE ST W",
            "city": "VARNVILLE",
            "state": "SC",
            "postal_code": "299444750",
            "telephone_number": "803-942-0532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA PEDIATRIC THERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-02",
        "last_updated": "2016-11-02",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "OWNER/SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "803-942-0532",
        "authorized_official_credential": "MA,CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "5345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SA1505",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Varnville, SC
• Providers in Varnville, SC by specialty
• Speech-Language Pathologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.