Purposeful Play Pediatric Therapy Services, PLLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

PURPOSEFUL PLAY PEDIATRIC THERAPY SERVICES, PLLC

Practice address

657 Self Hollow Rd
Rockford, TN 37853

Phone

(865) 963-5569

NPI assigned

Oct 12, 2020

Last updated

Oct 12, 2020By 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

Michelle Prach, MS, CCC-SLPNPI 1467079988

Title

SLP/Owner

Phone

(865) 963-5569

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michelle Prach, CCC-SLP

  • Speech-Language Pathologist
  • Fountain City, TN
  • NPI 1467079988
  NPD Authorized official

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

{
    "created_epoch": "1602460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602460800000",
    "number": "1710585823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 S PINE ST",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045102",
            "telephone_number": "815-793-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 SELF HOLLOW RD",
            "city": "ROCKFORD",
            "state": "TN",
            "postal_code": "37853",
            "telephone_number": "865-963-5569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURPOSEFUL PLAY PEDIATRIC THERAPY SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-12",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-08",
        "status": "A",
        "authorized_official_last_name": "PRACH",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "SLP/OWNER",
        "authorized_official_telephone_number": "865-963-5569",
        "authorized_official_credential": "MS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q058420",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Bowers, FNP-C
• Tiffany Poore, M.S. CCC-SLP
• Susan J Scharpf, MD
• Takuo Sonoda, M.D.

• Speech-Language Pathologist in Rockford, TN
• Providers in Rockford, TN by specialty
• Speech-Language Pathologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; 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.