Pediatric Play Therapy, LLC

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

Legal business name

PEDIATRIC PLAY THERAPY, LLC

Practice address

1709 Tommys Rd
Goldsboro, NC 27534-7991

Phone

(919) 736-8580

NPI assigned

Feb 5, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Valerie Charmaine Bellgrantham

Title

Ceo

Phone

(919) 736-8580

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pediatric Play Therapy, LLC Former legal business name

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217462400000",
    "number": "1427196906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 TOMMYS RD",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275347991",
            "telephone_number": "919-736-8580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 TOMMYS RD",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275347991",
            "telephone_number": "919-736-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PLAY THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2008-07-31",
        "status": "A",
        "authorized_official_last_name": "BELLGRANTHAM",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_middle_name": "CHARMAINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-736-8580",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300049",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Play Therapy, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Niyati Shyam Patel, DO
• Shreyang Hemonsuroy Patel, MD
• Allison Paugh, PMHNP
• Nakia Pearson, CSAC-R. CPSS
• Marc Peck
• Hector Manuel Pedraza, M.D.
• Connie Pender, PHARMD
• Krystal Ann Pendergraft
• Christian Penister
• Philip Pennington

• Rehabilitation Practitioner in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• Rehabilitation Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; 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.