Superkidz Pediatric Therapy, LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT4566 Issued in SC

Legal business name

SUPERKIDZ PEDIATRIC THERAPY, LLC

Practice address

1700 Quail Lake Dr
West Columbia, SC 29169-3746

Phone

(803) 509-3459

NPI assigned

Feb 17, 2016

Organization subpart

No

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

Authorized official

Name

Kim Caldwell

Title

Cota

Phone

(803) 509-3495

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1455667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455667200000",
    "number": "1730548918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 QUAIL LAKE DR",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693746",
            "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": "2016-02-17",
        "last_updated": "2016-02-17",
        "status": "A",
        "authorized_official_last_name": "CALDWELL",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "COTA",
        "authorized_official_telephone_number": "803-509-3495"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "OT4566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mark Joseph Sutherland, MD
• SVS Hydration & Wellness Lounge, LLC
• Michelle Swancey
• Whitney Makenzie Swann, DO
• Scott M Sweazy, M.D.

• 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 Feb 17, 2016; 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.