NPIMap

Organization Active NPI

Homegrown Pediatric Therapy, LLC

  • Occupational Therapist
  • Hartsville, SC
National Provider Identifier
1770209397
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
HOMEGROWN PEDIATRIC THERAPY, LLC
Practice address
1428 Crab Apple LN
Hartsville, SC 29550-8258
Phone
(843) 432-6791
Fax
(888) 388-0830
NPI assigned
Oct 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Authorized official

Name
Tiffany S Logan, COTANPI 1447961818
Title
Owner
Phone
(843) 432-6791

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 224Z00000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

1428 Crab Apple LN
Hartsville, SC 29550-8258

Mailing address

1428 Crab Apple LN
Hartsville, SC 29550-8258
Phone (843) 432-6791

Other names 1

  • Home Grown Pediatric Therapy LLC Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1665705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665705600000",
    "number": "1770209397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 CRAB APPLE LN",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295508258",
            "telephone_number": "843-432-6791",
            "fax_number": "888-388-0830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 CRAB APPLE LN",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295508258",
            "telephone_number": "843-432-6791",
            "fax_number": "888-388-0830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMEGROWN PEDIATRIC THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-14",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-432-6791",
        "authorized_official_credential": "COTA"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home Grown Pediatric Therapy LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hartsville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; 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.