NPIMap

Organization Active NPI

Springtide Child Development, Inc.

  • Speech-Language Pathologist
  • Dedham, MA
National Provider Identifier
1144989187
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
SPRINGTIDE CHILD DEVELOPMENT, INC.
Practice address
95 Eastern Ave Ste 8
Dedham, MA 02026-4582
Phone
(203) 998-6678
Fax
(203) 987-3099
NPI assigned
Dec 16, 2021
Organization subpart
Yes
Parent organization
SPRINGTIDE CHILD DEVELOPMENT, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

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

Authorized official

Name
Monica Hammel
Title
Credentialing Manager
Phone
(765) 461-5410

Specialties & licenses 2

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

Addresses

Primary practice location

95 Eastern Ave Ste 8
Dedham, MA 02026-4582

Mailing address

PO Box 358096
Pittsburgh, PA 15251-5096
Phone (203) 998-6678

Other practice location 1

910 Boston Tpke Ste 3
Shrewsbury, MA 01545-3396
Phone (203) 998-6678

National Provider Directory

National Provider Directory
Tax ID family
Springtide Child Development Inc2 organizations share this tax ID, including this one
Part of
Springtide Child Development Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

95 Eastern Ave
Ste 8
Dedham, MA 02026
Phone (203) 998-6678

95 Eastern Ave
Ste 12
Dedham, MA 02026
Phone (203) 998-6678

910 Boston Tpke
Ste 3
Shrewsbury, MA 01545
Phone (203) 998-6678

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1639612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640217600000",
    "number": "1144989187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 358096",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152515096",
            "telephone_number": "203-998-6678",
            "fax_number": "203-987-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 EASTERN AVE STE 8",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020264582",
            "telephone_number": "203-998-6678",
            "fax_number": "203-987-3099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "910 Boston Tpke Ste 3",
            "address_purpose": "LOCATION",
            "city": "Shrewsbury",
            "state": "MA",
            "postal_code": "015453396",
            "country_code": "US",
            "telephone_number": "203-998-6678",
            "fax_number": "203-987-3099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPRINGTIDE CHILD DEVELOPMENT, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPRINGTIDE CHILD DEVELOPMENT, INC",
        "enumeration_date": "2021-12-16",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A",
        "authorized_official_last_name": "HAMMEL",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "765-461-5410"
    },
    "taxonomies": [
        {
            "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 Dedham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; 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.