Thera-Peds, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

THERA-PEDS, LLC

Practice address

115 Progress Pkwy
Sullivan, MO 63080-2359

Phone

(573) 468-3373

NPI assigned

Aug 19, 2015

Organization subpart

No

Locations

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

Authorized official

Name

Laura Peregoy, OTR/L

Title

Manager

Phone

(573) 259-1425

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451347200000",
    "number": "1962878488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10276 TIMMERMANN LN",
            "city": "SULLIVAN",
            "state": "MO",
            "postal_code": "630806436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 PROGRESS PKWY",
            "city": "SULLIVAN",
            "state": "MO",
            "postal_code": "630802359",
            "telephone_number": "573-468-3373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERA-PEDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-19",
        "last_updated": "2015-12-29",
        "status": "A",
        "authorized_official_last_name": "PEREGOY",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "573-259-1425",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Team Diagnostics LLC
• Matthew J Tiefenbrunn, M.D.
• Sharon A Titter, MPT
• Amy E Torres, AGACNP-BC
• Megan S Turnbough, FNP
• United Seating and Mobility LLC

• All providers in Sullivan, MO
• Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; 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.