NPIMap

Organization Active NPI

Sheridan Speech Therapy

  • Early Intervention Provider Agency
  • Raceland, KY
National Provider Identifier
1336591163
Registry record updated Jul 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
141919 Issued in KY
Legal business name
SHERIDAN SPEECH THERAPY
Practice address
3040 Preakness CT
Raceland, KY 41169-1093
Phone
(740) 479-2395
NPI assigned
Jul 5, 2016
Last updated
Jul 5, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2016

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

Authorized official

Name
Mrs. Jill Renee Sheridan, MA, CCC SNPI 1467768523
Title
Speech Pathologist/Owner
Phone
(740) 479-2395

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X 141919 KY Primary

Addresses

Primary practice location

3040 Preakness CT
Raceland, KY 41169-1093

Mailing address

3040 Preakness CT
Raceland, KY 41169-1093
Phone (740) 479-2395

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": "1467676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467676800000",
    "number": "1336591163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 PREAKNESS CT",
            "city": "RACELAND",
            "state": "KY",
            "postal_code": "411691093",
            "telephone_number": "740-479-2395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 PREAKNESS CT",
            "city": "RACELAND",
            "state": "KY",
            "postal_code": "411691093",
            "telephone_number": "740-479-2395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHERIDAN SPEECH THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-05",
        "last_updated": "2016-07-05",
        "status": "A",
        "authorized_official_last_name": "SHERIDAN",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "SPEECH PATHOLOGIST/OWNER",
        "authorized_official_telephone_number": "740-479-2395",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA, CCC S"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "KY",
            "license": "141919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raceland, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.