NPIMap

Organization Active NPI

Knoxville Integrated Developmental Services, Inc.

  • Speech-Language Pathologist
  • Knoxville, TN
National Provider Identifier
1457525446
Registry record updated May 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
KNOXVILLE INTEGRATED DEVELOPMENTAL SERVICES, INC.
Practice address
9047 Executive Park Dr
Suite 115
Knoxville, TN 37923-4605
Phone
(865) 539-1928
Fax
(865) 539-6461
NPI assigned
Apr 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2009

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

Authorized official

Name
Samantha Rodgers
Title
HR/It Manager
Phone
(865) 539-1928

Specialties & licenses 1

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

Addresses

Primary practice location

9047 Executive Park Dr
Suite 115
Knoxville, TN 37923-4605

Mailing address

9047 Executive Park Dr
Suite 115
Knoxville, TN 37923-4605
Phone (865) 539-1928

Other identifiers 1

IdentifierTypeStateIssuer
4177096OtherTNBCBS

Other names 1

  • KIDS Rehab Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242259200000",
    "number": "1457525446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9047 EXECUTIVE PARK DR",
            "address_2": "SUITE 115",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234605",
            "telephone_number": "865-539-1928",
            "fax_number": "865-539-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9047 EXECUTIVE PARK DR",
            "address_2": "SUITE 115",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234605",
            "telephone_number": "865-539-1928",
            "fax_number": "865-539-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOXVILLE INTEGRATED DEVELOPMENTAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2009-05-14",
        "status": "A",
        "authorized_official_last_name": "RODGERS",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "HR/IT MANAGER",
        "authorized_official_telephone_number": "865-539-1928"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4177096",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KIDS Rehab",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2009; 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.