Paterson Pediatric Therapy LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

PATERSON PEDIATRIC THERAPY LLC

Practice address

2422 Laurens St
Grovetown, GA 30813-3441

Phone

(210) 787-9744

NPI assigned

Feb 3, 2026

Last updated

Feb 3, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Scout JohnsonNPI 1104777531

Title

Speech-Language Pathologist

Phone

(210) 787-9744

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Scout Virginia Johnson

  • Speech-Language Pathologist
  • Grovetown, GA
  • NPI 1104777531

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1770076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770076800000",
    "number": "1902757339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2422 LAURENS ST",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308133441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2422 LAURENS ST",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308133441",
            "telephone_number": "210-787-9744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATERSON PEDIATRIC THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-03",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SCOUT",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "210-787-9744"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyley Pahe, MS, RD, LD
• Terance Parker
• Tiffany Nicole Parks, M.D.
• Wallace Allen Partridge Jr., PHARMACIST
• Jay M. Patel, PHARM.D.
• Patriots Park Dental
• Peacceful at Home LLC
• Yashate Kinkia Pendergrass, RN
• Oscar G Pete
• Randall Erik Peterson, M.D.

• Speech-Language Pathologist in Grovetown, GA
• Providers in Grovetown, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2026; 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.