NPIMap

Organization Active NPI

Interact Pediatric Therapy Services, PLLC

  • Speech-Language Pathologist
  • Greensboro, NC
National Provider Identifier
1740505346
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
INTERACT PEDIATRIC THERAPY SERVICES, PLLC
Practice address
3907 W Market St # a
Greensboro, NC 27407-1303
Phone
(336) 772-5499
Fax
(336) 740-9099
NPI assigned
Apr 7, 2010
Last updated
Jan 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Authorized official

Name
Deanna Cole Reyes, OT/LNPI 1265554547
Title
OT/L; Co-Owner
Phone
(336) 279-9008

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 4531 NC
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 3223 NC
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

3907 W Market St # a
Greensboro, NC 27407-1303

Mailing address

5603 W Friendly Ave Ste B
#274
Greensboro, NC 27410-4252
Phone (336) 772-5499

Other identifiers 1

IdentifierTypeStateIssuer
7200380MedicaidNC

National Provider Directory

National Provider Directory

Locations

1305 W Wendover Ave
Ste C
Greensboro, NC 27408
Phone (336) 279-9008

3907 W Market St
#A
Greensboro, NC 27407
Phone (336) 209-8147

5415 W Friendly Ave
Ste A
Greensboro, NC 27410
Phone (336) 772-5499

5603 W Friendly Ave
Ste B
Greensboro, NC 27410
Phone (336) 686-6894

5603B W Friendly Ave
Greensboro, NC 27410

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1270598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705449600000",
    "number": "1740505346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5603 W FRIENDLY AVE STE B",
            "address_2": "#274",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274104252",
            "telephone_number": "336-772-5499",
            "fax_number": "336-740-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3907 W MARKET ST # A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274071303",
            "telephone_number": "336-772-5499",
            "fax_number": "336-740-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERACT PEDIATRIC THERAPY SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-07",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_middle_name": "COLE",
        "authorized_official_title_or_position": "OT/L;  CO-OWNER",
        "authorized_official_telephone_number": "336-279-9008",
        "authorized_official_credential": "OT/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NC",
            "license": "4531",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "3223",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7200380",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; 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.