Superkidz Pediatric Therapy, LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

SUPERKIDZ PEDIATRIC THERAPY, LLC

Practice address

1700 Quail Lake Dr
West Columbia, SC 29169-3746

Phone

(803) 509-3459

NPI assigned

Jun 8, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Kimberly B Caldwell

Title

Ceo

Phone

(803) 509-3459

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433721600000",
    "number": "1699155317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2791",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292022791",
            "telephone_number": "803-509-3459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 QUAIL LAKE DR",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693746",
            "telephone_number": "803-509-3459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERKIDZ PEDIATRIC THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-08",
        "last_updated": "2015-06-08",
        "status": "A",
        "authorized_official_last_name": "CALDWELL",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "803-509-3459",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mark Joseph Sutherland, MD
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• Michelle Swancey
• Whitney Makenzie Swann, DO

• Occupational Therapist in West Columbia, SC
• Providers in West Columbia, SC by specialty
• Occupational Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.