Pediatric Therapy of Indiana, LLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

License

31001941A Issued in IN

Legal business name

PEDIATRIC THERAPY OF INDIANA, LLC

Practice address

9000 S County Road 800 W
Daleville, IN 47334-9420

Phone

(317) 379-1794

Fax

(317) 770-0535

NPI assigned

Dec 16, 2016

Last updated

Dec 16, 2016By 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

Mrs. Tyla Hudon, OTRNPI 1619191970

Title

President/Owner

Phone

(317) 379-1794

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.

• Tyla J. Hudon, OTR

  • Occupational Therapist
  • Noblesville, IN
  • NPI 1619191970
  NPD (past) Authorized official

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

{
    "created_epoch": "1481846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481846400000",
    "number": "1952845406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10653 KESTREL CT",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460607537",
            "telephone_number": "317-379-1794",
            "fax_number": "317-770-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 S COUNTY ROAD 800 W",
            "city": "DALEVILLE",
            "state": "IN",
            "postal_code": "473349420",
            "telephone_number": "317-379-1794",
            "fax_number": "317-770-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC THERAPY OF INDIANA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-16",
        "last_updated": "2016-12-16",
        "status": "A",
        "authorized_official_last_name": "HUDON",
        "authorized_official_first_name": "TYLA",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "317-379-1794",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "IN",
            "license": "31001941A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott A. Nichols
• Chad Norris, RBT
• Tayloranne O'Dette
• Caleb Robert Overpeck, M.D.
• Sophie Parkhurst
• Andy Pickle
• Daisy Pier
• Emilee Pugh
• McKenzie Resler
• Jasmine Ruby

• Rehabilitation Clinic/Center in Daleville, IN
• Providers in Daleville, IN by specialty
• Rehabilitation Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2016; 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.