NPIMap

Organization Active NPI

Springtide Child Development, Inc

  • Speech-Language Pathologist
  • Dedham, MA
National Provider Identifier
1417616673
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
SPRINGTIDE CHILD DEVELOPMENT, INC
Practice address
95 Eastern Ave Ste 12
Dedham, MA 02026-4582
Phone
(203) 998-6678
Fax
(203) 987-3099
NPI assigned
Dec 14, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Authorized official

Name
Jia Jia Ye
Title
Ceo
Phone
(203) 998-6678

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

95 Eastern Ave Ste 12
Dedham, MA 02026-4582

Mailing address

PO Box 358096
Pittsburgh, PA 15251-5096
Phone (203) 998-6678

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1639440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639440000000",
    "number": "1417616673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 358096",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152515096",
            "telephone_number": "203-998-6678",
            "fax_number": "203-987-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 EASTERN AVE STE 12",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020264582",
            "telephone_number": "203-998-6678",
            "fax_number": "203-987-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGTIDE CHILD DEVELOPMENT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-14",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A",
        "authorized_official_last_name": "YE",
        "authorized_official_first_name": "JIA JIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "203-998-6678"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dedham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; 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.