NPIMap

Organization Active NPI

Procare Therapy Services Inc.

  • Speech-Language Pathologist
  • Tifton, GA
National Provider Identifier
1336238245
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP004574 Issued in GA
Legal business name
PROCARE THERAPY SERVICES INC.
Practice address
607 42ND St E
Tifton, GA 31794-1549
Phone
(229) 392-3663
Fax
(229) 387-0568
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Shankar Narayan Viswanatha, SLPNPI 1730301433
Title
President
Phone
(229) 392-3663

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 SLP004574 GA Primary

Addresses

Primary practice location

607 42ND St E
Tifton, GA 31794-1549

Mailing address

607 42ND St E
Tifton, GA 31794-1549
Phone (229) 392-3663

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336238245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 42ND ST E",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317941549",
            "telephone_number": "229-392-3663",
            "fax_number": "229-387-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 42ND ST E",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317941549",
            "telephone_number": "229-392-3663",
            "fax_number": "229-387-0568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCARE THERAPY SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VISWANATHA",
        "authorized_official_first_name": "SHANKAR",
        "authorized_official_middle_name": "NARAYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "229-392-3663",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP004574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.