NPIMap

Organization Active NPI

Theratime Inc

  • Pediatric Physical Therapist
  • Sioux Falls, SD
National Provider Identifier
1508052739
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
0295 Issued in SD
Legal business name
THERATIME INC
Practice address
2115 S Pendar LN
Sioux Falls, SD 57105-3944
Phone
(605) 339-1800
Fax
(605) 339-1239
NPI assigned
Sep 20, 2007
Last updated
Sep 20, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2007

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

Authorized official

Name
Mr. Cory Michael FaberNPI 1063578243
Title
Ceo/President
Phone
(605) 339-1800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 0295 SD Primary
Pediatric Occupational Therapist 225XP0200X 0522 SD
Speech-Language Pathologist 235Z00000X 01100452 SD

Addresses

Primary practice location

2115 S Pendar LN
Sioux Falls, SD 57105-3944

Mailing address

2115 S Pendar LN
Sioux Falls, SD 57105-3944
Phone (605) 339-1800

Other identifiers 1

IdentifierTypeStateIssuer
5834750MedicaidSD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190246400000",
    "number": "1508052739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 S PENDAR LN",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571053944",
            "telephone_number": "605-339-1800",
            "fax_number": "605-339-1239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 S PENDAR LN",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571053944",
            "telephone_number": "605-339-1800",
            "fax_number": "605-339-1239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERATIME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-09-20",
        "status": "A",
        "authorized_official_last_name": "FABER",
        "authorized_official_first_name": "CORY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "605-339-1800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "SD",
            "license": "0295",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "SD",
            "license": "0522",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SD",
            "license": "01100452",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5834750",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; 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.