Providence Pediatric Therapy

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

Legal business name

PROVIDENCE PEDIATRIC THERAPY

Practice address

7616 W Courtney Campbell Cswy Unit 210
Tampa, FL 33607-1533

Phone

(815) 505-5545

NPI assigned

Apr 6, 2021

Organization subpart

No

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

Authorized official

Name

Miss Hannah Nicole Berge, OTR/LNPI 1336773910

Title

Occupational Therapist

Phone

(815) 505-5545

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Interoperability endpoints

• Direct secure messaging: info@providencepediatrictherapy.com

Practitioners 1

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

• Hannah Berge

  • Occupational Therapist
  • Tampa, FL
  • NPI 1336773910
  NPD Authorized official

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1477132579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7616 W COURTNEY CAMPBELL CSWY UNIT 210",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336071533",
            "telephone_number": "815-505-5545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7616 W COURTNEY CAMPBELL CSWY UNIT 210",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336071533",
            "telephone_number": "815-505-5545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE PEDIATRIC THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-06",
        "last_updated": "2025-09-11",
        "certification_date": "2021-04-06",
        "status": "A",
        "authorized_official_last_name": "BERGE",
        "authorized_official_first_name": "HANNAH",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "815-505-5545",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OT20551",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Info@providencepediatrictherapy.com",
            "affiliation": "N",
            "endpointDescription": "Business Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7616 W Courtney Campbell Cswy Unit 210",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336071533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dylan Thomas Prough, DPT
• Holly Lynn Provance, RPH
• Proven Services, Inc
• Derek Marc Provencher, PT, DPT
• Elizabeth A Provenzano, MSW
• Proximiti Technologies, Inc.
• John M Prpich II, MD
• Ainsley Prudhomme
• Joseph P Prunier
• Grace Pryor, MD, MPH

• Pediatric Physical Therapist in Tampa, FL
• Providers in Tampa, FL by specialty
• Pediatric Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.