NPIMap

Organization Active NPI

Thera-Play Pediatric Services

  • Speech-Language Pathologist
  • Fayetteville, AR
National Provider Identifier
1104165307
Registry record updated Feb 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
THERA-PLAY PEDIATRIC SERVICES
Practice address
3801 Main Dr Ste B
Fayetteville, AR 72704-6364
Phone
(479) 856-6400
Fax
(479) 856-6623
NPI assigned
Feb 7, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2013

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

Authorized official

Name
Erin Oliver, CCC-SLP
Title
Owner
Phone
(479) 856-6400

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

3801 Main Dr Ste B
Fayetteville, AR 72704-6364

Mailing address

3801 Main Dr Ste B
Fayetteville, AR 72704-6364
Phone (479) 856-6400

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1360195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360195200000",
    "number": "1104165307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 MAIN DR STE B",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727046364",
            "telephone_number": "479-856-6400",
            "fax_number": "479-856-6623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 MAIN DR STE B",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727046364",
            "telephone_number": "479-856-6400",
            "fax_number": "479-856-6623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERA-PLAY PEDIATRIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-07",
        "last_updated": "2013-02-07",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "479-856-6400",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; 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.