NPIMap

Organization Active NPI

Speech & Occupational Therapy Specialists

  • Multi-Specialty Clinic/Center
  • Danville, VA
National Provider Identifier
1902437841
Registry record updated May 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
SPEECH & OCCUPATIONAL THERAPY SPECIALISTS
Practice address
159 Executive Dr Ste a
Danville, VA 24541-4160
Phone
(434) 799-7732
Fax
(866) 468-5040
NPI assigned
Jan 29, 2020
Last updated
May 2, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2021

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

Authorized official

Name
Amie Teague Boone, MA/CCC-SLP
Title
Clinical Director
Phone
(434) 228-1812

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

159 Executive Dr Ste a
Danville, VA 24541-4160

Mailing address

PO Box 10864
Danville, VA 24543-5015
Phone (434) 799-7732

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200424000337 VA Part B Supplier - Clinic/Group Practice 4981034477 Receives reassigned benefits from 6 practitioners
Practice locations: Danville, VA
O20210610002427 VA Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 4981034477 Practice locations: Danville, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902437841. Details of each certification follow.

  • CCN 496761 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 496761

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
SPEECH & OCCUPATIONAL THERAPY SPECIALISTS
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Apr 20, 2022
Last certification
Apr 20, 2022
Ownership / control type
Proprietary
Facility address
159 Executive Drive Suite a
Danville, VA 24541

National Provider Directory

National Provider Directory

Locations

159 Executive Dr
Ste A
Danville, VA 24541
Phone (434) 799-7732

625 Piney Forest Rd
Ste 403
Danville, VA 24540
Phone (434) 799-7732

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619913600000",
    "number": "1902437841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10864",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245435015",
            "telephone_number": "434-799-7732",
            "fax_number": "866-468-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 EXECUTIVE DR STE A",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245414160",
            "telephone_number": "434-799-7732",
            "fax_number": "866-468-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEECH & OCCUPATIONAL THERAPY SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-29",
        "last_updated": "2021-05-02",
        "certification_date": "2021-05-02",
        "status": "A",
        "authorized_official_last_name": "BOONE",
        "authorized_official_first_name": "AMIE",
        "authorized_official_middle_name": "TEAGUE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "434-228-1812",
        "authorized_official_credential": "MA/CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

Verify at the official NPI Registry.