Pediatric Rehab

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

200119099 Issued in KY

Legal business name

PEDIATRIC REHAB

Practice address

5286 Parkside Dr
Paducah, KY 42001-7466

Phone

(270) 994-7751

NPI assigned

Jun 7, 2016

Last updated

Jun 7, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Libby Ann Bobo, MS

Title

President

Phone

(270) 994-7751

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Elizabeth Ann Bobo

  • Developmental Therapist
  • Paducah, KY
  • NPI 1881812303
  NPD (past)

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465257600000",
    "number": "1316396815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5286 PARKSIDE DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420017466",
            "telephone_number": "270-994-7751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5286 PARKSIDE DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420017466",
            "telephone_number": "270-994-7751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-07",
        "last_updated": "2016-06-07",
        "status": "A",
        "authorized_official_last_name": "BOBO",
        "authorized_official_first_name": "LIBBY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "270-994-7751",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "KY",
            "license": "200119099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penny Rae Payne, PA
• PCD Management of Paducah, LLC (PCD Management of Paducah)
• Emma Victoria Peal
• Megan Elizabeth Peck
• Pediatric Group of Paducah
• Rolanda Sue Peek-Fisk, LCSW
• Amy Allison Peek, APRN
• Shelby Peek
• Joel Ralph Pendergraft, RPH
• Heather Perdue, MS, CCC-SLP

• Early Intervention Provider Agency in Paducah, KY
• Providers in Paducah, KY by specialty
• Early Intervention Provider Agency in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; 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.