Innovative Pediatric Therapy Services LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

INNOVATIVE PEDIATRIC THERAPY SERVICES LLC

Practice address

713 Bridge St Ste 23
Selinsgrove, PA 17870-1250

Phone

(570) 266-5181

NPI assigned

Aug 24, 2020

Organization subpart

No

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

Authorized official

Name

Erin Mitrenko, OTR/L

Title

Owner

Phone

(570) 266-5181

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600387200000",
    "number": "1629680319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 S MARKET ST",
            "city": "SELINSGROVE",
            "state": "PA",
            "postal_code": "178701816",
            "telephone_number": "508-269-2747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 BRIDGE ST STE 23",
            "city": "SELINSGROVE",
            "state": "PA",
            "postal_code": "178701250",
            "telephone_number": "570-266-5181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE PEDIATRIC THERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-24",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A",
        "authorized_official_last_name": "MITRENKO",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-266-5181",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Selinsgrove, PA
• Providers in Selinsgrove, PA by specialty
• Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; 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.