Organization Active NPI

Great Start Therapy Associates, LLC

  • Speech-Language Pathologist
  • Holland, PA
National Provider Identifier
1629493598
Registry record updated Feb 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
GREAT START THERAPY ASSOCIATES, LLC
Practice address
295 Buck Rd
Suite 104
Holland, PA 18966-1733
Phone
(215) 485-5018
NPI assigned
Feb 28, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2014

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

Authorized official

Name
Yvonne M Blackwell
Title
Owner
Phone
(267) 252-8473

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

295 Buck Rd
Suite 104
Holland, PA 18966-1733

Mailing address

295 Buck Rd
Suite 104
Holland, PA 18966-1733
Phone (215) 485-5018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140516000706 PA Part B Supplier - Clinic/Group Practice 7618190877 Receives reassigned benefits from 2 practitioners
Practice locations: Holland, PA

National Provider Directory

National Provider Directory

Locations

295 Buck Rd
Ste 104
Holland, PA 18966
Phone (215) 485-5018

295 Buck Rd
Ste 110
Holland, PA 18966
Phone (215) 485-5018

295 Buck Rd
Ste 203
Southampton, PA 18966
Phone (215) 485-5018

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1393545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393545600000",
    "number": "1629493598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 BUCK RD",
            "address_2": "SUITE 104",
            "city": "HOLLAND",
            "state": "PA",
            "postal_code": "189661733",
            "telephone_number": "215-485-5018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 BUCK RD",
            "address_2": "SUITE 104",
            "city": "HOLLAND",
            "state": "PA",
            "postal_code": "189661733",
            "telephone_number": "215-485-5018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT START THERAPY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-28",
        "last_updated": "2014-02-28",
        "status": "A",
        "authorized_official_last_name": "BLACKWELL",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-252-8473"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.