Innovative Children's Therapy, Inc

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

Legal business name

INNOVATIVE CHILDREN'S THERAPY, INC

Practice address

5423 Lake Howell Rd
Winter Park, FL 32792-1033

Phone

(407) 679-7837

NPI assigned

Nov 13, 2006

Last updated

Jan 24, 2011By 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. Dayna Jill Brunette, MS, PTNPI 1881765725

Title

President

Phone

(407) 679-7837

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dayna Jill Brunette, MS, PT

  • Pediatric Physical Therapist
  • Winter Park, FL
  • NPI 1881765725

  Pediatrics

  NPD (past) Authorized official
• Trevor Marie Maclaren, MS, PT

  • Pediatric Physical Therapist
  • Winter Park, FL
  • NPI 1760553606

  Pediatrics

  NPD (past)
• Ariana Watson, OTR L

  • Pediatric Occupational Therapist
  • Winter Park, FL
  • NPI 1639240583

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295827200000",
    "number": "1083785810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4819 FISKE CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328264278",
            "telephone_number": "407-679-7837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5423 LAKE HOWELL RD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327921033",
            "telephone_number": "407-679-7837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE CHILDREN'S THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2011-01-24",
        "status": "A",
        "authorized_official_last_name": "BRUNETTE",
        "authorized_official_first_name": "DAYNA",
        "authorized_official_middle_name": "JILL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-679-7837",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, PT"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "FL",
            "license": null,
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890816800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Physical Therapist in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Pediatric Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2011; 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.