NPIMap

Organization Active NPI

Pediatric Therapies of Brevard, LLC

  • Speech-Language Pathologist
  • Melbourne, FL
National Provider Identifier
1285058412
Registry record updated Feb 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 4022 Issued in FL
Legal business name
PEDIATRIC THERAPIES OF BREVARD, LLC
Practice address
4353 Pinewood Rd
Melbourne, FL 32934-9071
Phone
(321) 749-1863
Fax
(321) 751-3185
NPI assigned
Feb 7, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2014

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

Authorized official

Name
Terri A Allerton, M.A.CCC/SLPNPI 1063514545
Title
Owner
Phone
(321) 749-1863

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: 193200000X MULTI-SPECIALTY GROUP 235Z00000X SA 4022 FL Primary

Addresses

Primary practice location

4353 Pinewood Rd
Melbourne, FL 32934-9071

Mailing address

4353 Pinewood Rd
Melbourne, FL 32934-9071
Phone (321) 749-1863

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": "1391731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391731200000",
    "number": "1285058412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4353 PINEWOOD RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329349071",
            "telephone_number": "321-749-1863",
            "fax_number": "321-751-3185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4353 PINEWOOD RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329349071",
            "telephone_number": "321-749-1863",
            "fax_number": "321-751-3185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC THERAPIES OF BREVARD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-07",
        "last_updated": "2014-02-07",
        "status": "A",
        "authorized_official_last_name": "ALLERTON",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-749-1863",
        "authorized_official_credential": "M.A.CCC/SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 4022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2014; 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.