NPIMap

Organization Active NPI

Riverside Speech & Language

  • Developmental Therapist
  • Bradenton, FL
National Provider Identifier
1265745467
Registry record updated Jul 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Legal business name
RIVERSIDE SPEECH & LANGUAGE
Practice address
2620 Manatee Ave W
Suite C
Bradenton, FL 34205-4944
Phone
(941) 807-2863
NPI assigned
Jul 16, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2010

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

Authorized official

Name
Amy Royall, MSCCCSLPNPI 1003970013
Title
Owner
Phone
(941) 807-2863

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
Developmental TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 222Q00000X Primary

Addresses

Primary practice location

2620 Manatee Ave W
Suite C
Bradenton, FL 34205-4944

Mailing address

808 Hillcrest Dr
Bradenton, FL 34209-1846

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Riverside Speech Language2 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.

Locations

2620 Manatee Ave W
Ste C
Bradenton, FL 34205
Phone (727) 804-6795

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279238400000",
    "number": "1265745467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 HILLCREST DR",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342091846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 MANATEE AVE W",
            "address_2": "SUITE C",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342054944",
            "telephone_number": "941-807-2863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE SPEECH & LANGUAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-16",
        "last_updated": "2010-07-16",
        "status": "A",
        "authorized_official_last_name": "ROYALL",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-807-2863",
        "authorized_official_credential": "MSCCCSLP"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2010; 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.