Interactive Therapy Services, Inc.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

6402 Issued in MN

Legal business name

INTERACTIVE THERAPY SERVICES, INC.

Practice address

2495 Maplewood Dr Ste 313
Maplewood, MN 55109-1913

Phone

(651) 770-8884

NPI assigned

Oct 9, 2006

Organization subpart

No

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

Authorized official

Name

Julie Ernest

Title

Owner

Phone

(651) 770-8884

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Functional Kids Doing business as

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456876800000",
    "number": "1215024468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2495 MAPLEWOOD DR STE 313",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091985",
            "telephone_number": "651-770-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 MAPLEWOOD DR STE 313",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091913",
            "telephone_number": "651-770-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERACTIVE THERAPY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2016-03-02",
        "status": "A",
        "authorized_official_last_name": "ERNEST",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-770-8884"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "6402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CBSA",
            "identifier": "4600382",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "54M22IN",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U CARE",
            "identifier": "J033",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "75-732",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "4600382",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Functional Kids",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Speech-Language Pathologist in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; 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.