NPIMap

Organization Active NPI

Kidabilities Pediatric Therapy Center

  • Early Intervention Provider Agency
  • Middlesboro, KY
National Provider Identifier
1700318656
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
KIDABILITIES PEDIATRIC THERAPY CENTER
Practice address
2801 US Highway 25 E
Suite 98
Middlesboro, KY 40965-2069
Phone
(606) 545-2631
NPI assigned
Mar 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Authorized official

Name
Leigh S Roark, SLPNPI 1003026881
Title
SLP/Owner
Phone
(606) 545-2631

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X KY
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X KY
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

2801 US Highway 25 E
Suite 98
Middlesboro, KY 40965-2069

Mailing address

535 J Goodin Branch Rd
Barbourville, KY 40906-8159
Phone (606) 545-2631

National Provider Directory

National Provider Directory

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": "1490832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684281600000",
    "number": "1700318656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 J GOODIN BRANCH RD",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409068159",
            "telephone_number": "606-545-2631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 US HIGHWAY 25 E",
            "address_2": "SUITE 98",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409652069",
            "telephone_number": "606-545-2631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDABILITIES PEDIATRIC THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-30",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A",
        "authorized_official_last_name": "ROARK",
        "authorized_official_first_name": "LEIGH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SLP/OWNER",
        "authorized_official_telephone_number": "606-545-2631",
        "authorized_official_credential": "SLP"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlesboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; 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.