Nutrio Pediatric Therapy, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

NUTRIO PEDIATRIC THERAPY, LLC

Practice address

405 Fairdale Dr
Simpsonville, SC 29681-4450

Phone

(561) 985-1455

NPI assigned

Aug 23, 2024

Last updated

Aug 23, 2024By 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

Tara Shingleton, CCC-SLPNPI 1194341115

Title

Owner

Phone

(561) 985-1455

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.

• Tara Martin Shingleton, CF-SLP

  • Speech-Language Pathologist
  • Spartanburg, SC
  • NPI 1194341115
  NPD Authorized official

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

{
    "created_epoch": "1724371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724371200000",
    "number": "1932932035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 FAIRDALE DR",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296814450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 FAIRDALE DR",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296814450",
            "telephone_number": "561-985-1455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRIO PEDIATRIC THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-23",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A",
        "authorized_official_last_name": "SHINGLETON",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-985-1455",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walter Gerrard Nivens
• Laureen Judy Noll, MD
• Addison Norris
• Kevin Loren Norris, MD
• Northland Hearing Centers, Inc. (Hearing Healthcare Center, Inc)
• Ryan A O'Bleness, D.C.
• Julie O'Connor
• Amanda Gayle O'Kelly, M.D.
• Ryan O'Malley, DDS
• Chelsie O'Sullivan, DMD

• Speech-Language Pathologist in Simpsonville, SC
• Providers in Simpsonville, SC by specialty
• Speech-Language Pathologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; 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.