NPIMap

Organization Active NPI

Missoula Pediatric Therapy Center Inc

Doing business as Kidzoola Therapy Center

  • Occupational Therapist
  • Missoula, MT
National Provider Identifier
1891263034
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
MISSOULA PEDIATRIC THERAPY CENTER INC
Doing business as
Kidzoola Therapy Center
Practice address
2321 S 3Rd St W
Missoula, MT 59801-1332
Phone
(406) 214-3131
NPI assigned
Nov 6, 2018
Last updated
Sep 28, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Authorized official

Name
Damon Simmons, OTR/LNPI 1740310085
Title
President
Phone
(312) 404-4578

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 6

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X NU
Physical Therapist 225100000X NU
Physical Therapy Assistant 225200000X NU
Occupational Therapist 225X00000X NU Primary
Speech-Language Assistant 2355S0801X NU
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

2321 S 3Rd St W
Missoula, MT 59801-1332

Mailing address

2321 S 3Rd St W
Missoula, MT 59801-1332
Phone (406) 214-3131

Other names 1

  • Kidzoola Therapy Center Doing business as

National Provider Directory

National Provider Directory

Locations

2321 S 3rd St W
Missoula, MT 59801
Phone (406) 214-3131

2683 Palmer St
Ste B
Missoula, MT 59808
Phone (406) 214-3131

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632787200000",
    "number": "1891263034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2321 S 3RD ST W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598011332",
            "telephone_number": "406-214-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2321 S 3RD ST W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598011332",
            "telephone_number": "406-214-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOULA PEDIATRIC THERAPY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-06",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "DAMON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-404-4578",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kidzoola Therapy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.