Active NPI
Thrive Therapy
- Speech-Language Pathologist
- Portales, NM
National Provider Identifier
1164243531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Legal business name
- THRIVE THERAPY
- Practice address
- 107 Yucca Dr
Portales, NM 88130-7126 - Phone
- (575) 749-4348
- NPI assigned
- Oct 18, 2024
- Last updated
- Oct 18, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Teresa Blyze
- Title
- Credentialling Manager
- Phone
- (575) 291-9659
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Primary |
Addresses
Primary practice location
107 Yucca Dr
Portales, NM 88130-7126
Mailing address
107 Yucca Dr
Portales, NM 88130-7126
Phone (575) 749-4348
National Provider Directory
National Provider DirectoryLocations
2325 N Main St
Ste B
Clovis, NM 88101
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Speech-Language Pathologist
- Roswell, NM
- NPI 1912883000
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729209600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1729209600000",
"number": "1164243531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 YUCCA DR",
"city": "PORTALES",
"state": "NM",
"postal_code": "881307126",
"telephone_number": "575-749-4348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 YUCCA DR",
"city": "PORTALES",
"state": "NM",
"postal_code": "881307126",
"telephone_number": "575-749-4348"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THRIVE THERAPY",
"organizational_subpart": "NO",
"enumeration_date": "2024-10-18",
"last_updated": "2024-10-18",
"certification_date": "2024-10-18",
"status": "A",
"authorized_official_last_name": "BLYZE",
"authorized_official_first_name": "TERESA",
"authorized_official_title_or_position": "CREDENTIALLING MANAGER",
"authorized_official_telephone_number": "575-291-9659"
},
"taxonomies": [
{
"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 Portales, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.