NPIMap

Organization Active NPI

Pediatric Potentials Therapy

  • Speech-Language Pathologist
  • Coral Springs, FL
National Provider Identifier
1619255015
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
PEDIATRIC POTENTIALS THERAPY
Practice address
9750 NW 33Rd St
Suite 209
Coral Springs, FL 33065-4042
Phone
(305) 321-4343
Fax
(954) 827-0308
NPI assigned
Aug 2, 2011
Last updated
Mar 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Authorized official

Name
Kristina Webster, MACCC-SLPNPI 1831420843
Title
SLP/Owner
Phone
(305) 321-4343

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 224Z00000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 2355S0801X
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X SA 10752 FL
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

9750 NW 33Rd St
Suite 209
Coral Springs, FL 33065-4042

Mailing address

9750 NW 33Rd St
Suite 209
Coral Springs, FL 33065-4042
Phone (305) 321-4343

National Provider Directory

National Provider Directory

Locations

9750 NW 33rd St
Ste 209
Coral Springs, FL 33065
Phone (954) 509-3776

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1312243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647216000000",
    "number": "1619255015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9750 NW 33RD ST",
            "address_2": "SUITE 209",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330654042",
            "telephone_number": "305-321-4343",
            "fax_number": "954-827-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9750 NW 33RD ST",
            "address_2": "SUITE 209",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330654042",
            "telephone_number": "305-321-4343",
            "fax_number": "954-827-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC POTENTIALS THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-02",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "WEBSTER",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "SLP/OWNER",
        "authorized_official_telephone_number": "305-321-4343",
        "authorized_official_credential": "MACCC-SLP"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 10752",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; 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.