NPIMap

Organization Active NPI

Magnolia Rehab Services

Doing business as Magnolia Pediatric Therapy

  • Speech-Language Pathologist
  • Destin, FL
National Provider Identifier
1902118540
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
MAGNOLIA REHAB SERVICES
Doing business as
Magnolia Pediatric Therapy
Practice address
151 Regions Way Ste 2a
Destin, FL 32541-5107
Phone
(850) 424-5469
Fax
(850) 424-5592
NPI assigned
Jul 12, 2010
Last updated
Sep 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Authorized official

Name
Caitlin Calloway
Title
Owner
Phone
(678) 361-3491

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA 9011 FL
Speech-Language Pathologist 235Z00000X NU Primary

Addresses

Primary practice location

151 Regions Way Ste 2a
Destin, FL 32541-5107

Mailing address

151 Regions Way Ste 2a
Destin, FL 32541-5107
Phone (850) 424-5469

Other names 1

  • Magnolia Pediatric Therapy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Magnolia Rehab Services6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

151 Regions Way
Ste 2A
Destin, FL 32541
Phone (850) 424-5469

12671 Emerald Coast Pkwy W
Fl 2
Miramar Beach, FL 32550

Practitioners & affiliated clinicians

Practitioners 2

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": "1278892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664409600000",
    "number": "1902118540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 REGIONS WAY STE 2A",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325415107",
            "telephone_number": "850-424-5469",
            "fax_number": "850-424-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 REGIONS WAY STE 2A",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325415107",
            "telephone_number": "850-424-5469",
            "fax_number": "850-424-5592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA REHAB SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-12",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A",
        "authorized_official_last_name": "CALLOWAY",
        "authorized_official_first_name": "CAITLIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-361-3491"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 9011",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Pediatric Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Magnolia Pediatric Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Destin, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.