Andalusia Therapy Group, LLC
Organization Active NPI Speech-Language Pathologist · Andalusia, AL
NPI 1891542833 · NPPES record last updated Jul 7, 2024
Key facts
- NPI
- 1891542833
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- Legal business name
- ANDALUSIA THERAPY GROUP, LLC
- Practice address
- 224 S Three Notch St
Andalusia, AL 36420-3710 - Phone
- (606) 344-7997
- NPI assigned
- May 6, 2024
- Organization subpart
- No
Authorized official
- Name
- Kirby Soles Sewell
- Title
- Owner
- Phone
- (606) 344-7997
Practitioners 2
-
Sera Pelham Carnley, MS.,CCC-SLP
-
Kirby S Sewell, RN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240712003783 | AL | Part B Supplier - Clinic/Group Practice | 3971048091 |
Receives reassigned benefits from 1 practitioner Practice locations: Andalusia, AL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist |
225X00000X | |||
| Speech-Language Pathologist |
235Z00000X | Yes |
Addresses
Primary practice location
224 S Three Notch St
Andalusia, AL 36420-3710
Mailing address
224 S Three Notch St
Andalusia, AL 36420-3710
Phone (606) 344-7997
Other providers in Andalusia, AL
- Andalusia Physician Practices LLC
- Andalusia Physician Practices LLC
- Andalusia Physician Practices LLC
- Andalusia Professional Services LLC
- Andalusia Rescue Squad, Inc.
- Landon B Anderson
- Joann Armstong
- Austin Jeffery Bailey
- Horace J Bailey
- Bailey'S Pharmacy, Inc.
All providers in Andalusia, AL · Speech-Language Pathologist in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.