Organization Active NPI

Discovery Playground, Inc

  • Developmental Therapist
  • Fayetteville, NC
National Provider Identifier
1447500285
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Legal business name
DISCOVERY PLAYGROUND, INC
Practice address
5948 Fisher Rd
Fayetteville, NC 28304
Phone
(910) 423-5622
Fax
(910) 378-1755
NPI assigned
Sep 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Authorized official

Name
Jennifer L Dibb, CCC-SLP
Title
President
Phone
(910) 423-5622

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 222Q00000X NC Primary

Addresses

Primary practice location

5948 Fisher Rd
Fayetteville, NC 28304

Mailing address

4602 Cumberland Rd
Fayetteville, NC 28306-2412
Phone (910) 423-5622

Other identifiers 1

IdentifierTypeStateIssuer
8300019MedicaidNC

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.

NPI Registry JSON

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615766400000",
    "number": "1447500285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4602 CUMBERLAND RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283062412",
            "telephone_number": "910-423-5622",
            "fax_number": "910-378-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5948 FISHER RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28304",
            "telephone_number": "910-423-5622",
            "fax_number": "910-378-1755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISCOVERY PLAYGROUND, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-19",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A",
        "authorized_official_last_name": "DIBB",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-423-5622",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Developmental Therapist",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8300019",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.