NPIMap

Organization Active NPI

Pediatric Therapy Services, Inc.

  • Clinic/Center
  • Brandon, FL
National Provider Identifier
1871769349
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PEDIATRIC THERAPY SERVICES, INC.
Practice address
206 Ridgewood Ave
Brandon, FL 33510
Phone
(813) 662-1060
Fax
(813) 662-0530
NPI assigned
May 5, 2008
Last updated
Aug 20, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2018

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

Authorized official

Name
Graham Kilburn
Title
Owner/President
Phone
(813) 662-1060

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary
Customized Equipment (DME) 332BC3200X PT2549 FL
Pediatric Physical Therapist 2251P0200X PT5990 FL
Pediatric Occupational Therapist 225XP0200X OT1478 FL
Speech-Language Pathologist 235Z00000X SA7398 FL

Addresses

Primary practice location

206 Ridgewood Ave
Brandon, FL 33510

Mailing address

206 Ridgewood Ave
Brandon, FL 33510-4617
Phone (813) 662-1060

Other identifiers 8

IdentifierTypeStateIssuer
664175OtherFLAETNA
Y906FOtherFLBLUE CROSS BLUE SHIELD
024393800MedicaidFL
8803579-04MedicaidFL
13424302OtherFLCITRUS COMMERCIAL/HMO
6406221OtherFLUNITED HEALTHCARE
8810363001OtherFLCIGNA
8803579-01MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Therapy Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

206 Ridgewood Ave
Brandon, FL 33510
Phone (813) 662-1060

Practitioners & affiliated clinicians

Practitioners 58

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 58

NPI Registry JSON

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534723200000",
    "number": "1871769349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 RIDGEWOOD AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335104617",
            "telephone_number": "813-662-1060",
            "fax_number": "813-662-0530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 RIDGEWOOD AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "33510",
            "telephone_number": "813-662-1060",
            "fax_number": "813-662-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC THERAPY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-05",
        "last_updated": "2018-08-20",
        "status": "A",
        "authorized_official_last_name": "KILBURN",
        "authorized_official_first_name": "GRAHAM",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "813-662-1060"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "FL",
            "license": "PT2549",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "FL",
            "license": "PT5990",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OT1478",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA7398",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "664175",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y906F",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024393800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8803579-04",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CITRUS COMMERCIAL/HMO",
            "identifier": "13424302",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "6406221",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8810363001",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8803579-01",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; 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.