Progressive Pediatric Rehab, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3111 Issued in SC

Legal business name

PROGRESSIVE PEDIATRIC REHAB, LLC

Practice address

6250 Woodside Executive CT
Aiken, SC 29803-3822

Phone

(803) 649-0981

NPI assigned

Jun 14, 2008

Last updated

Jun 14, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Patricia A. Miller, MSP, CCC-SLP

Title

Speech Language Pathologist

Phone

(803) 649-0981

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1213401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213401600000",
    "number": "1073773859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7144",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298047144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6250 WOODSIDE EXECUTIVE CT",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298033822",
            "telephone_number": "803-649-0981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE PEDIATRIC REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-14",
        "last_updated": "2008-06-14",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "803-649-0981",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSP, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "3111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SA0380",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cara Priest, PT, DPT
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• Progressive Physical Therapy, PA (Progressive Physical Therapy North Aiken)
• Ashley Jarratt Protzman, NP-C
• Pruitthealth - Aiken, LLC (PruittHealth - Aiken)
• Pruitthealth Home Health, Inc. (PruittHealth Home Health - Aiken)
• Pruitthealth Hospice, Inc. (PruittHealth Hospice - Aiken)

• Speech-Language Pathologist in Aiken, SC
• Providers in Aiken, 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 Jun 14, 2008; 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.