Kidsprout Therapy

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

KIDSPROUT THERAPY

Practice address

10405 Stallion Way
Bahama, NC 27503-9631

Phone

(919) 641-1803

Fax

(919) 287-2869

NPI assigned

Jan 9, 2014

Last updated

Apr 18, 2022By 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

Sajina Cooper

Title

Administrative Director

Phone

(919) 641-1803

Specialties & licenses 5

Addresses

Tax ID family

Kidsprout Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Kidsprout Therapy

  • Speech-Language Pathologist
  • Bahama, NC
  • NPI 1144568726
  NPD tax ID

Locations

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.

• Madeleine Leeds

  • Developmental Therapist
  • Durham, NC
  • NPI 1063986164
  NPD (past)

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

{
    "created_epoch": "1389225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650240000000",
    "number": "1184046278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10405 STALLION WAY",
            "city": "BAHAMA",
            "state": "NC",
            "postal_code": "275039631",
            "telephone_number": "919-641-1803",
            "fax_number": "919-287-2869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10405 STALLION WAY",
            "city": "BAHAMA",
            "state": "NC",
            "postal_code": "275039631",
            "telephone_number": "919-641-1803",
            "fax_number": "919-287-2869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDSPROUT THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-09",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "SAJINA",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "919-641-1803"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Bahama, NC
• Providers in Bahama, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; 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.