Therapy Source LLC

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

THERAPY SOURCE LLC

Practice address

3311 Beach Blvd
Jacksonville, FL 32207-3704

Phone

(904) 396-1462

Fax

(904) 396-1199

NPI assigned

Jul 2, 2007

Organization subpart

Yes

Parent organization

CEREBRAL PALSY OF NORTHEAST FLORIDA, INC.As reported in NPPES

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

Authorized official

Name

Ms. Holly C Peters

Title

Ceo

Phone

(904) 396-1462

Specialties & licenses 4

Addresses

Tax ID family

Therapy Source LLC2 organizations share this tax ID, including this one

Part of

New Heights of Northeast Florida Inc

Other organizations with this tax ID 1

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

• Therapy Source, LLC

  • Developmentally Disabled Services Day Training Agency
  • Jacksonville, FL
  • NPI 1841337060
  NPD tax ID

Locations

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1245437359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3311 BEACH BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073704",
            "telephone_number": "904-396-1462",
            "fax_number": "904-396-1199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 BEACH BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073704",
            "telephone_number": "904-396-1462",
            "fax_number": "904-396-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPY SOURCE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CEREBRAL PALSY OF NORTHEAST FLORIDA, INC.",
        "enumeration_date": "2007-07-02",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-396-1462",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theramed Medical Associates LLC
• Theramed, LLC
• Therapeutic BD Services, LLC
• Therapeutic Consulting Associates, LLC
• Theraplay Jax LLC
• Therapy Source, LLC
• Therapy-Interventions
• Therapyworks of Jacksonville Inc
• Therapyworks of Jacksonville Inc
• Theresa a. Inman, Inc.

• Early Intervention Provider Agency in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Early Intervention Provider Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; 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.