Therawide, LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

THERAWIDE, LLC

Practice address

591 Collins Dr Apt 6
Merced, CA 95348-3178

Phone

(310) 307-9114

NPI assigned

Feb 13, 2020

Organization subpart

No

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

Authorized official

Name

Brandon Hightower

Title

Ceo/Director of Operations

Phone

(310) 307-9114

Specialties & licenses 3

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1581552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581552000000",
    "number": "1831722206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "591 COLLINS DR APT 6",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953483178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "591 COLLINS DR APT 6",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953483178",
            "telephone_number": "310-307-9114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAWIDE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-13",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A",
        "authorized_official_last_name": "HIGHTOWER",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "CEO/DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "310-307-9114"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "secure@therawide.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "591 Collins Dr Apt 6",
            "city": "Merced",
            "state": "CA",
            "country_code": "US",
            "postal_code": "953483178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Occupational Therapist in Merced, CA
• Providers in Merced, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; 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.