Kredo Home Therapy LLC.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

KREDO HOME THERAPY LLC.

Practice address

14328 Magnolia Ridge Loop
Winter Garden, FL 34787-5353

Phone

(407) 906-1942

NPI assigned

Feb 10, 2019

Organization subpart

No

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

Authorized official

Name

Jason Cornell

Title

Director

Phone

(407) 848-6912

Specialties & licenses 5

Addresses

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

{
    "created_epoch": "1549756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549756800000",
    "number": "1639634025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14328 MAGNOLIA RIDGE LOOP",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347875353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14328 MAGNOLIA RIDGE LOOP",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347875353",
            "telephone_number": "407-906-1942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KREDO HOME THERAPY LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-10",
        "last_updated": "2019-02-10",
        "status": "A",
        "authorized_official_last_name": "CORNELL",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "407-848-6912"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Winter Garden, FL
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• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.