Gracent Pediatric Therapies - Indiana, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

GRACENT PEDIATRIC THERAPIES - INDIANA, LLC

Practice address

5525 Abbe Wood Dr
Newburgh, IN 47630-0040

Phone

(812) 483-9980

NPI assigned

Aug 28, 2024

Last updated

Oct 2, 2024By 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

Michael McKellar

Title

Cfo

Phone

(865) 567-0756

Specialties & licenses 5

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.

• Sarah M Gray

  • Behavior Technician
  • Naperville, IL
  • NPI 1174447965
  NPD (past)

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727827200000",
    "number": "1316771793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 LEE ST STE 105",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600166556",
            "telephone_number": "865-567-0756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 ABBE WOOD DR",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476300040",
            "telephone_number": "812-483-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACENT PEDIATRIC THERAPIES - INDIANA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A",
        "authorized_official_last_name": "MCKELLAR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "865-567-0756"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guy Kulumanu Goodness, MSN, BSN, RN, FNP-C
• Stacy L Gore, DPT
• James Edwin Goris, M.D.
• Patrick Robert Gottfried, DC
• Renee Gough
• Kelly Jo Gramig
• Adam Thomas Grant
• Samantha Gray, LSW
• Elizabeth Green, RN
• Jonathan Green, P.A.

• Behavior Analyst in Newburgh, IN
• Providers in Newburgh, IN by specialty
• Behavior Analyst in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.