Progressive Pediatric Therapy Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05002749A Issued in IN

Legal business name

PROGRESSIVE PEDIATRIC THERAPY INC.

Practice address

3910 Harrison Creek CT
Mishawaka, IN 46544-9159

Phone

(574) 254-0028

Fax

(574) 254-0039

NPI assigned

Nov 20, 2006

Last updated

Jul 13, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Helen J Melnick, PT

Title

President

Phone

(574) 340-3567

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184284800000",
    "number": "1710051560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 HARRISON CREEK CT",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465449159",
            "telephone_number": "574-254-0028",
            "fax_number": "574-254-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 HARRISON CREEK CT",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465449159",
            "telephone_number": "574-254-0028",
            "fax_number": "574-254-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE PEDIATRIC THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-13",
        "status": "A",
        "authorized_official_last_name": "MELNICK",
        "authorized_official_first_name": "HELEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-340-3567",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05002749A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; 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.