The Texas Institute of Developmental Pediatrics

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

THE TEXAS INSTITUTE OF DEVELOPMENTAL PEDIATRICS

Doing business as

Sam's Adventure Camp

Practice address

2204 Trolley CV
Leander, TX 78641-2098

Phone

(303) 552-4418

NPI assigned

Jul 24, 2019

Last updated

Jul 24, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mary Jones

Title

Founder- Executive Director

Phone

(303) 552-4418

Specialties & licenses 6

Addresses

Other names 1

• Sam's Adventure Camp Doing business as

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563926400000",
    "number": "1538713904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 TROLLEY CV",
            "city": "LEANDER",
            "state": "TX",
            "postal_code": "786412098",
            "telephone_number": "303-552-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 TROLLEY CV",
            "city": "LEANDER",
            "state": "TX",
            "postal_code": "786412098",
            "telephone_number": "303-552-4418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE TEXAS INSTITUTE OF DEVELOPMENTAL PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-24",
        "last_updated": "2019-07-24",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "FOUNDER- EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "303-552-4418"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225A00000X",
            "taxonomy_group": "",
            "desc": "Music Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2050X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care Camp",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sam's Adventure Camp",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Therapist in Leander, TX
• Providers in Leander, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.