Pediatric Physical Therapy Services, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PEDIATRIC PHYSICAL THERAPY SERVICES, INC.

Practice address

80 Professional CT
Lafayette, IN 47905-5152

Phone

(765) 448-1758

Fax

(765) 448-3898

NPI assigned

Dec 19, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Jamie Sue Stormont-Smith, PT PCS

Title

Owner President

Phone

(765) 448-1758

Specialties & licenses 4

Addresses

Other identifiers 2

Tax ID family

Pediatric Physical Therapy Services Inc2 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.

• Pediatric Physical Therapy Services Inc

  • Physical Therapist
  • Lafayette, IN
  • NPI 1598923443
  NPD tax ID

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326153600000",
    "number": "1710040803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 PROFESSIONAL CT",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055152",
            "telephone_number": "765-448-1758",
            "fax_number": "765-448-3898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 PROFESSIONAL CT",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055152",
            "telephone_number": "765-448-1758",
            "fax_number": "765-448-3898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PHYSICAL THERAPY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2012-01-10",
        "status": "A",
        "authorized_official_last_name": "STORMONT-SMITH",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "765-448-1758",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT PCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST STEPS",
            "identifier": "200715730",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200070900A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Mae Pearson, MD
• Jill C Pease, PHYSICIAN ASSISTANT
• Dixie J Pederson, PH.D.
• Pediatric Associates of Lafayette, P.C.
• Pediatric Physical Therapy Services Inc
• Kayla Lynne Pellam, BS
• Jeffrey Alan Penman, M.D.
• Karen Pennington, NP
• Rachel Erin Pennington, CST/CSFA
• Stefanie Peregrin, OCCUPATIONAL THERAPI

• Physical Therapist in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; 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.