NPIMap

Organization Active NPI

Nourish Pediatric Therapy, LLC

  • Clinic/Center
  • Orlando, FL
National Provider Identifier
1265942205
Registry record updated Dec 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
NOURISH PEDIATRIC THERAPY, LLC
Practice address
1900 Jake St Unit 105
Orlando, FL 32814-5915
Phone
(407) 227-8370
NPI assigned
Oct 4, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2017

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

Authorized official

Name
Amanda Stevens, MS, CCC-SLPNPI 1972978070
Title
Speech-Language Pathologist
Phone
(407) 227-8370

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X FL
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X FL
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X FL
Early Intervention Provider Agency 252Y00000X FL
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1900 Jake St Unit 105
Orlando, FL 32814-5915

Mailing address

1900 Jake St Unit 105
Orlando, FL 32814-5915
Phone (407) 227-8370

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1507075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512086400000",
    "number": "1265942205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 JAKE ST UNIT 105",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328145915",
            "telephone_number": "407-227-8370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 JAKE ST UNIT 105",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328145915",
            "telephone_number": "407-227-8370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOURISH PEDIATRIC THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-04",
        "last_updated": "2017-12-01",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "407-227-8370",
        "authorized_official_credential": "MS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2017; 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.