NPIMap

Organization Active NPI

Little Red Wagon Pediatric Therapy, LLC

  • Speech-Language Pathologist
  • Fort Worth, TX
National Provider Identifier
1831569052
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
LITTLE RED WAGON PEDIATRIC THERAPY, LLC
Practice address
4524 Boat Club Rd Ste 180
Fort Worth, TX 76135-7025
Phone
(817) 764-3825
NPI assigned
Sep 30, 2015
Last updated
Mar 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Authorized official

Name
Gabriela GoodwinNPI 1598134546
Title
Owner
Phone
(817) 764-3825

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

4524 Boat Club Rd Ste 180
Fort Worth, TX 76135-7025

Mailing address

4524 Boat Club Rd Ste 180
Fort Worth, TX 76135-7025
Phone (817) 764-3825

Other practice location 1

6013 Reef Point Ln
Fort Worth, TX 76135-2099
Phone (817) 764-3825

National Provider Directory

National Provider Directory

Locations

4524 Boat Club Rd
Ste 180
Fort Worth, TX 76135
Phone (817) 764-3825

6013 Reef Point Ln
Fort Worth, TX 76135
Phone (817) 764-3825

6013 Reef Point Ln
Ste 401
Fort Worth, TX 76135
Phone (817) 238-8555

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1831569052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4524 BOAT CLUB RD STE 180",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761357025",
            "telephone_number": "817-764-3825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4524 BOAT CLUB RD STE 180",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761357025",
            "telephone_number": "817-764-3825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6013 Reef Point Ln",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761352099",
            "country_code": "US",
            "telephone_number": "817-764-3825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LITTLE RED WAGON PEDIATRIC THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-30",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "GABRIELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-764-3825"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.