Upsurge Therapy Services

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

UPSURGE THERAPY SERVICES

Practice address

1603 Adirondac Way
Bonaire, GA 31005-5615

Phone

(229) 630-4445

NPI assigned

Jan 11, 2023

Organization subpart

No

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

Authorized official

Name

Stephanie Black, SLP

Title

Owner

Phone

(229) 630-4445

Specialties & licenses 1

Addresses

Other names 1

• Upsurge Therapy Services, LLC Other name

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

{
    "created_epoch": "1673395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698192000000",
    "number": "1194439414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 ADIRONDAC WAY",
            "city": "BONAIRE",
            "state": "GA",
            "postal_code": "310055615",
            "telephone_number": "229-630-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 ADIRONDAC WAY",
            "city": "BONAIRE",
            "state": "GA",
            "postal_code": "310055615",
            "telephone_number": "229-630-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSURGE THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-11",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-630-4445",
        "authorized_official_credential": "SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Upsurge Therapy Services, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ashley Damon Thwaites, LMFT
• TLC of Georgia LLC
• Gabriel Toms, PHARMD
• Breanna Marie Trueblood, OTR/L
• Dona Michelle Tuten II, NP
• William Shane Valigora, DPT
• Vitaltrans Logistics LLC
• James D Waddell, D.C.
• Jenna Walton, FNP-C
• Chrystal Wasden

• Speech-Language Pathologist in Bonaire, GA
• Providers in Bonaire, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.