Flourishing Kids Therapy & Lactation LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

FLOURISHING KIDS THERAPY & LACTATION LLC

Practice address

1600 Heritage LNDG Ste 201
Saint Peters, MO 63303-8488

Phone

(636) 748-0170

NPI assigned

Dec 12, 2023

Organization subpart

No

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

Authorized official

Name

Jodie Wallis, CLC, MS, CCC-SLPNPI 1154934172

Title

Owner/Pediatric Feeding Specialist

Phone

(636) 748-0170

Specialties & licenses 1

Addresses

Other names 1

• From the Heart Feeding and Lactation LLC Former legal business name

Practitioners 1

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.

• Jodie Wallis, CLC, MS, CCC-SLP

  • Speech-Language Pathologist
  • Saint Peters, MO
  • NPI 1154934172
  NPD Authorized official

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

{
    "created_epoch": "1702339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708214400000",
    "number": "1598533226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 HERITAGE LNDG STE 201",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633038488",
            "telephone_number": "636-748-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 HERITAGE LNDG STE 201",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633038488",
            "telephone_number": "636-748-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLOURISHING KIDS THERAPY & LACTATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-12",
        "last_updated": "2024-02-18",
        "certification_date": "2024-02-18",
        "status": "A",
        "authorized_official_last_name": "WALLIS",
        "authorized_official_first_name": "JODIE",
        "authorized_official_title_or_position": "OWNER/PEDIATRIC FEEDING SPECIALIST",
        "authorized_official_telephone_number": "636-748-0170",
        "authorized_official_credential": "CLC, MS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "From the Heart Feeding and Lactation LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "From the Heart Feeding and Lactation LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Speech-Language Pathologist in Saint Peters, MO
• Providers in Saint Peters, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2024; 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.