NPIMap

Organization Active NPI

Great Adventures Therapy LLC

  • Speech-Language Pathologist
  • Knoxville, TN
National Provider Identifier
1275105488
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
GREAT ADVENTURES THERAPY LLC
Practice address
12854 Pecos Rd
Knoxville, TN 37934-0884
Phone
(615) 516-1702
Fax
(865) 674-5447
NPI assigned
Jul 15, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Authorized official

Name
Mrs. Chariti Skinner, M.S. CCC-SLPNPI 1699036509
Title
Owner/Speech Language Pathologist
Phone
(615) 516-1702

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 Primary

Addresses

Primary practice location

12854 Pecos Rd
Knoxville, TN 37934-0884

Mailing address

12854 Pecos Rd
Knoxville, TN 37934-0884
Phone (615) 516-1702

Other identifiers 1

IdentifierTypeStateIssuer
Q152866MedicaidTN

National Provider Directory

National Provider Directory

Locations

9000 Executive Park Dr
Ste A205
Knoxville, TN 37923
Phone (865) 236-0103

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": "1626307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1275105488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12854 PECOS RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379340884",
            "telephone_number": "615-516-1702",
            "fax_number": "865-674-5447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12854 PECOS RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379340884",
            "telephone_number": "615-516-1702",
            "fax_number": "865-674-5447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT ADVENTURES THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-15",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "SKINNER",
        "authorized_official_first_name": "CHARITI",
        "authorized_official_title_or_position": "OWNER/SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "615-516-1702",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q152866",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.