Full Spectrum Pediatric Therapy

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

2324 Issued in TN

Legal business name

FULL SPECTRUM PEDIATRIC THERAPY

Practice address

298 Warfield Blvd Ste C
Clarksville, TN 37043-1828

Phone

(931) 906-0440

NPI assigned

Jun 18, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Lana Kareen Broome, OTR/LNPI 1487706701

Title

Occupational Therapist/Owner

Phone

(931) 906-0440

Specialties & licenses 1

Addresses

Tax ID family

Full Spectrum Pediatric Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Full Spectrum Pediatric Therapy, Inc.

  • Physical Therapist
  • Clarksville, TN
  • NPI 1255472403
  NPD tax ID

Practitioners 1

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

• Lana Kareen Broome, OTR

  • Occupational Therapist
  • Clarksville, TN
  • NPI 1487706701
  NPD Authorized official

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

{
    "created_epoch": "1403049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403049600000",
    "number": "1679987606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "298 WARFIELD BLVD STE C",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370431828",
            "telephone_number": "931-906-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 WARFIELD BLVD STE C",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370431828",
            "telephone_number": "931-906-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL SPECTRUM PEDIATRIC THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-18",
        "last_updated": "2014-06-18",
        "status": "A",
        "authorized_official_last_name": "BROOME",
        "authorized_official_first_name": "LANA",
        "authorized_official_middle_name": "KAREEN",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "931-906-0440",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "TN",
            "license": "2324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Frost, MS, LMFT
• FRPG, LLC
• Amanda Jean Fryer, FNP-C
• Erien Wynne Fryer
• Gregory Marcel Fryer, M.D.
• Full Spectrum Pediatric Therapy, Inc.
• Fuller Rehabilitation and Consulting Services Inc.
• Danielle Fuller, R.N.
• Jessica Fuller, RBT
• Kiah Fuller

• Occupational Therapy Assistant in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Occupational Therapy Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2014; 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.