Epic Pediatric Therapy, LP

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

License

648140018 Issued in TX

Legal business name

EPIC PEDIATRIC THERAPY, LP

Doing business as

Aveanna Healthcare

Practice address

915 W Exchange Pkwy Ste 100
Allen, TX 75013-7018

Phone

(214) 547-1571

Fax

(817) 789-6849

NPI assigned

Jul 1, 2006

Last updated

Jan 27, 2025By 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

Matthew Buckhalter

Title

Cfo

Phone

(470) 464-8000

Specialties & licenses 12

Addresses

Other names 1

• Aveanna Healthcare Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366471450. Details of each certification follow.

• CCN 456606 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 456606

Legal name

AVEANNA HEALTHCARE

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Jun 6, 1989

Last certification

Feb 11, 2020

Ownership / control type

Proprietary

Most recent change of ownership

Nov 11, 1999

Facility address

915 W Exchange Parkwy Ste 100
Allen, TX 75013

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Epic Pediatric Therapy, LP.

  dba Aveanna Healthcare

  • Rehabilitation Clinic/Center
  • Arlington, TX
  • NPI 1013163377

  7012826852

  Same PAC ID

Locations

Practitioners 25

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.

• Gabriela Maria Banda Zapata, M.S., CF-SLP

  • Speech-Language Pathologist
  • Garland, TX
  • NPI 1740175165
  NPD (past)
• Colleen Kimberly Bauer, PT, DPT

  • Physical Therapist
  • Garland, TX
  • NPI 1023409240
  NPD (past)
• Natalie Brouillette, SLP

  • Speech-Language Pathologist
  • Allen, TX
  • NPI 1922265750
  NPD (past)
• Alice Marie Burgett, PT

  • Physical Therapist
  • Allen, TX
  • NPI 1124415930
  NPD (past)
• Trena Ilene Cauthon

  • Occupational Therapist
  • Amarillo, TX
  • NPI 1619231032
  NPD (past)
• Linda Kay Comer, COTA

  • Occupational Therapist
  • Amarillo, TX
  • NPI 1053675702
  NPD (past)
• Martha Lorena Cruz

  • Speech-Language Pathologist
  • Garland, TX
  • NPI 1134038482
  NPD (past)
• Deirdre Delcambre-Thigpen, MS SLP

  • Speech-Language Assistant
  • Beaumont, TX
  • NPI 1306153911
  NPD (past)
• Mandy Elswick

  • Speech-Language Pathologist
  • Longview, TX
  • NPI 1164775466
  NPD (past)
• Jacqueline Gonzalez

  • Speech-Language Pathologist
  • Garland, TX
  • NPI 1578459442
  NPD (past)
• Maggie Hayes, OTR

  • Occupational Therapist
  • Amarillo, TX
  • NPI 1891032314
  NPD (past)
• Jillian Herbert, OTR/L

  • Occupational Therapist
  • Garland, TX
  • NPI 1396103149
  NPD (past)

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1366471450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 INTERSTATE NORTH PKWY SE STE 1600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395047",
            "telephone_number": "470-464-8000",
            "fax_number": "770-248-8192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 W EXCHANGE PKWY STE 100",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750137018",
            "telephone_number": "214-547-1571",
            "fax_number": "817-789-6849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "930 W Centerville Rd Ste 930C",
            "address_purpose": "LOCATION",
            "city": "Garland",
            "state": "TX",
            "postal_code": "750415823",
            "country_code": "US",
            "telephone_number": "972-303-7021",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "98 Briggs St Ste 990",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782241287",
            "country_code": "US",
            "telephone_number": "210-226-9536",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6601 Montana Ave Ste G&h",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799252155",
            "country_code": "US",
            "telephone_number": "915-838-7604",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Saint Louis Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761043377",
            "country_code": "US",
            "telephone_number": "817-921-5020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EPIC PEDIATRIC THERAPY, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "BUCKHALTER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "470-464-8000"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "013311",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "648140002",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "648140015",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "648140009",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "648140006",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "648140018",
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "648140024",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "648140022",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "648140005",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "648140023",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "648140017",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "648140021",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aveanna Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christopher Carlito Enriquez, PA-C, LAT, ATC
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• Envital Healthcare Inc
• Enzo BC LLC (Assisting Hands East Plano)
• Epsilon Anesthesia Associates PLLC
• Equip Speech Services PLLC
• Eric Andersen PA
• Erick Gonzalez, Psy.D. PLLC
• Courtney Erickson, LM, CPM

• Rehabilitation Clinic/Center in Allen, TX
• Providers in Allen, TX by specialty
• Rehabilitation Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.