NPIMap

Organization Active NPI

Thrive and Shine Speech Therapy, Inc.

  • Speech-Language Pathologist
  • Beverly Hills, CA
National Provider Identifier
1245620384
Registry record updated Jun 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
20444 Issued in CA
Legal business name
THRIVE AND SHINE SPEECH THERAPY, INC.
Practice address
292 S la Cienega Blvd
#250
Beverly Hills, CA 90211-3330
Phone
(310) 954-9614
Fax
(310) 526-6561
NPI assigned
Jan 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2015

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

Authorized official

Name
Neda Rezapoor, M.S.NPI 1275876674
Title
Ceo
Phone
(310) 866-9958

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 20444 CA Primary

Addresses

Primary practice location

292 S la Cienega Blvd
#250
Beverly Hills, CA 90211-3330

Mailing address

PO Box 3215
Beverly Hills, CA 90212-0215
Phone (310) 954-9614

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150327002340 CA Part B Supplier - Clinic/Group Practice 8123345246 Receives reassigned benefits from 1 practitioner
Practice locations: Beverly Hills, CA

National Provider Directory

National Provider Directory

Locations

292 S La Cienega Blvd
Ste 250
Beverly Hills, CA 90211
Phone (310) 866-9958

Practitioners & affiliated clinicians

Practitioners 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1422403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433980800000",
    "number": "1245620384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3215",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902120215",
            "telephone_number": "310-954-9614",
            "fax_number": "310-526-6561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 S LA CIENEGA BLVD",
            "address_2": "#250",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902113330",
            "telephone_number": "310-954-9614",
            "fax_number": "310-526-6561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THRIVE AND SHINE SPEECH THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-28",
        "last_updated": "2015-06-11",
        "status": "A",
        "authorized_official_last_name": "REZAPOOR",
        "authorized_official_first_name": "NEDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-866-9958",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "20444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.