Appalachian Pediatric Therapy, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

APPALACHIAN PEDIATRIC THERAPY, LLC

Practice address

5400 Fort Henry Dr Ste 12
Kingsport, TN 37663-5304

Phone

(423) 426-3304

NPI assigned

Sep 29, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Wendi Young Minutolo, BCBA, LBANPI 1003365503

Title

Co-Owner/Lba

Phone

(423) 426-3304

Specialties & licenses 1

Addresses

Electronic endpoints 2

Locations

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

• Wendi Y Minutolo

  • Behavior Analyst
  • Johnson City, TN
  • NPI 1003365503
  NPD Authorized official

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601337600000",
    "number": "1104433630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 PATRICK HENRY CIR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376633733",
            "telephone_number": "423-426-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 FORT HENRY DR STE 12",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376635304",
            "telephone_number": "423-426-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPALACHIAN PEDIATRIC THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-29",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-23",
        "status": "A",
        "authorized_official_last_name": "MINUTOLO",
        "authorized_official_first_name": "WENDI",
        "authorized_official_middle_name": "YOUNG",
        "authorized_official_title_or_position": "CO-OWNER/LBA",
        "authorized_official_telephone_number": "423-426-3304",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BCBA, LBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "wyminutolo@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5400 Fort Henry Dr Ste 12",
            "city": "Kingsport",
            "state": "TN",
            "country_code": "US",
            "postal_code": "376635304",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "wyminutolo@gmail.com",
            "affiliation": "N",
            "address_1": "5400 Fort Henry Dr Ste 12",
            "city": "Kingsport",
            "state": "TN",
            "country_code": "US",
            "postal_code": "376635304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Kingsport, TN
• Behavior Analyst in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.