NPIMap

Organization Active NPI

Pediatric Therapy Achievements, LLC

  • Speech-Language Pathologist
  • Johnston, SC
National Provider Identifier
1821395658
Registry record updated Feb 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3298 Issued in SC
Legal business name
PEDIATRIC THERAPY ACHIEVEMENTS, LLC
Practice address
43 Aviary LN
Johnston, SC 29832-2658
Phone
(803) 640-3984
NPI assigned
Feb 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2011

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

Authorized official

Name
Tracie L Brazell, MA, CCC-SLP
Title
Speech-Language Pathologist
Phone
(803) 640-3984

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 3298 SC Primary

Addresses

Primary practice location

43 Aviary LN
Johnston, SC 29832-2658

Mailing address

43 Aviary LN
Johnston, SC 29832-2658
Phone (803) 640-3984

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1297641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297641600000",
    "number": "1821395658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 AVIARY LN",
            "city": "JOHNSTON",
            "state": "SC",
            "postal_code": "298322658",
            "telephone_number": "803-640-3984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 AVIARY LN",
            "city": "JOHNSTON",
            "state": "SC",
            "postal_code": "298322658",
            "telephone_number": "803-640-3984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC THERAPY ACHIEVEMENTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-14",
        "last_updated": "2011-02-14",
        "status": "A",
        "authorized_official_last_name": "BRAZELL",
        "authorized_official_first_name": "TRACIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "803-640-3984",
        "authorized_official_credential": "MA, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "3298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; 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.