PEDIATRIC THERAPY CLINIC (NPI# 1629203054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629203054 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC THERAPY CLINIC |
| Practice Address |
708 Broadwater Ave Billings MT 59101-2710 |
| Mailing Address |
1610 Poly Dr Billings MT 59102-1724 |
| Practice Telephone | 4062591680 |
| Practice Fax Number | 4062591777 |
| Mailing Telephone | 4062591680 |
| Mailing Fax Number | 4062591777 |
| Enumeration Date | 2009-05-29 |
| Last Update Date | 2018-12-19 |
| Authorized Official Name | MR. TRACI L SELL (SLP/BCBA/OWNER) |
| Authorized Official Telephone | 4062591680 |
| Authorized Official Credential | M.S. CCC-SLP, BC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QH0700X |
Clinic/Center Specialization: Hearing and Speech |
Ambulatory Health Care Facilities | ||
| N | 224ZF0002X |
Occupational Therapy Assistant Specialization: Feeding, Eating & Swallowing |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 225XP0200X |
Occupational Therapist Specialization: Pediatrics |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013445857 | Pediatric Therapy Clinic | Clinic/Center | 1610 Poly Dr, Billings, MT 59102-1724 | 2017-05-24 |
| Street Address |
708 BROADWATER AVE |
| City | BILLINGS |
| State | MT |
| Zip Code | 59101-2710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972544617 | David F. Johnson | Internal Medicine | 708 Broadwater Ave, Billings, MT 59101-2710 | 2006-06-10 |
| 1770182545 | Cathy Breeding | Behavior Technician | 708 Broadwater Ave, Billings, MT 59101-2710 | 2020-10-22 |
| 1467051441 | Meghan Knust | Behavior Technician | 708 Broadwater Ave, Billings, MT 59101-2710 | 2020-10-21 |
| 1396343968 | Morghan Huff | Behavior Technician | 708 Broadwater Ave, Billings, MT 59101-2710 | 2020-10-15 |
| 1124626122 | Saydee Preston | Behavior Technician | 708 Broadwater Ave, Billings, MT 59101-2710 | 2020-10-12 |
| 1437761954 | Josephine Kautsky | Physical Therapist | 708 Broadwater Ave, Billings, MT 59101-2710 | 2020-08-17 |
| 1447878665 | Kelly Rysavy | Behavior Technician | 708 Broadwater Ave, Billings, MT 59101-2710 | 2020-07-14 |
| 1447878798 | Amanda Iffland | Behavior Technician | 708 Broadwater Ave, Billings, MT 59101-2710 | 2020-07-13 |
| 1639795024 | Kourtney Friede | Behavior Technician | 708 Broadwater Ave, Billings, MT 59101-2710 | 2020-06-22 |
| 1144843905 | Alexis Egan | Behavior Technician | 708 Broadwater Ave, Billings, MT 59101-2710 | 2020-05-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356950927 | Rayola Carol Grant | Student in an Organized Health Care Education/Training Program | Montana State University College of Nursing, Billing Ce, Ap 306 1500 University Drive, Billings, MT 59101 | 2020-07-29 |
| 1225652001 | Johnny L Talawyma Jr. | Peer Specialist | 1230 N. 30th St. Suite 100, Billings, MT 59101 | 2020-06-08 |
| 1306487962 | Jeannine L. Walter | Technician | 26 Peters St, Billings, MT 59101 | 2019-10-04 |
| 1912470089 | Deidre Jenae Johnson | Student in an Organized Health Care Education/Training Program | 1500 University Drive, Rimrock 503, Billings, MT 59101 | 2019-01-10 |
| 1649743964 | Annika Stampfel | Behavior Technician | 780 Broadwater Avenue, Billings, MT 59101 | 2019-01-09 |
| 1215436092 | Yellowstone City-county Health Department | Clinic/Center | 515 N 27th St, Billings, MT 59101 | 2018-02-07 |
| 1902305790 | Yellowstone City-county Health Department | Clinic/Center | 3005 1st Ave S, Billings, MT 59101 | 2018-02-07 |
| 1720587512 | Yellowstone City-county Health Department | Clinic/Center | 120 Jackson Street, Billings, MT 59101 | 2018-02-07 |
| 1508385477 | Jkw & Jira Inc. | Pharmacy | 1245 N 29th St Ste 100, Billings, MT 59101 | 2017-09-12 |
| 1487198610 | Rebecca Webber | Counselor | 251 Rolling Meadow Dr, Billings, MT 59101 | 2016-12-07 |
| Find all providers in zip 59101 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811466147 | Shari Reinhardt | Speech-Language Pathologist | 1838 Alderson Ave, Billings, MT 59102-4016 | 2018-11-15 |
| 1003383092 | Brooke Leigh Oftedal | Speech-Language Pathologist | 1750 Morocco Dr, Billings, MT 59105-5430 | 2018-10-27 |
| 1952766156 | Joetta Marie Anderson | Speech-Language Pathologist | 1597 Avenue D Ste D, Billings, MT 59102-3010 | 2015-12-15 |
| 1952770687 | Christina Hansen | Speech-Language Pathologist | 2616 Poly Dr Apt B, Billings, MT 59102-1444 | 2015-09-23 |
| 1740671940 | Lisa Harris | Speech-Language Pathologist | 5207 Onyx Blvd, Billings, MT 59106-3214 | 2015-02-09 |
| 1033515481 | Rock Creek Teletherapy, LLC | Speech-Language Pathologist | 1302 24th St W, Suite 132, Billings, MT 59102-3861 | 2014-11-12 |
| 1407296304 | Ashley Ariel Hennessy | Speech-Language Pathologist | 1610 Poly Dr, Billings, MT 59102-1724 | 2013-06-25 |
| 1447528989 | Christine Marie O'leary | Speech-Language Pathologist | 3440 Granger Ave S, #33, Billings, MT 59102-7061 | 2011-12-12 |
| 1821384470 | Susan H. Hogan | Speech-Language Pathologist | 3120 Green Terrace Dr, Billings, MT 59102-0632 | 2011-06-22 |
| 1770885816 | Teresa L. Hammerquist | Speech-Language Pathologist | 1537 Colton Blvd, Billings, MT 59102-2440 | 2010-11-22 |
| Find all providers in BILLINGS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.