THERA-PEDS, LLC (NPI# 1962878488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962878488 |
| Entity Type | Organization |
| Organization Name | THERA-PEDS, LLC |
| Practice Address |
115 Progress Pkwy Sullivan MO 63080-2359 |
| Mailing Address |
10276 Timmermann Ln Sullivan MO 63080-6436 |
| Practice Telephone | 5734683373 |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2015-12-29 |
| Authorized Official Name | LAURA PEREGOY (MANAGER) |
| Authorized Official Telephone | 5732591425 |
| Authorized Official Credential | OTR/L |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Street Address |
115 PROGRESS PKWY |
| City | SULLIVAN |
| State | MO |
| Zip Code | 63080-2359 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356382790 | Ltc Providers, Inc | Durable Medical Equipment & Medical Supplies | 115 Progress Pkwy, Sullivan, MO 63080-2359 | 2006-06-09 |
| 1568904050 | Nicole Edwin | Speech-Language Pathologist | 115 Progress Pkwy, Sullivan, MO 63080-2359 | 2016-11-15 |
| 1396865663 | Ltc Providers, Inc. | Durable Medical Equipment & Medical Supplies | 115 Progress Pkwy, Sullivan, MO 63080-2359 | 2007-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669896650 | Lindsay Nicole Arnette | Physical Therapist | 940 Mattox Drive, Meramec Nursing Center, Sullivan, MO 63080 | 2014-02-11 |
| 1407099500 | Victorian Manor of Sullivan | Assisted Living Facility | 1250 East Springfield Rd, Sullivan, MO 63080 | 2009-04-20 |
| 1578729992 | Bio-medical Applications of Missouri, Inc. | Clinic/Center | 123 Progress Parkway, Sullivan, MO 63080 | 2008-08-05 |
| 1386826089 | Sellers Family Chiropractic PC | Chiropractor | 405 Wal Mart Drive, Sullivan, MO 63080 | 2007-12-04 |
| 1740495282 | Tasha Marie Rodriguez | Physical Therapist | 107 Congress Dr., Sullivan, MO 63080 | 2007-05-10 |
| 1033261649 | Clyde William Sellers II | Chiropractor | 405 Walmart Dr., Sullivan, MO 63080 | 2007-01-17 |
| 1407954209 | Sara Skidmore | Occupational Therapist | 2022 Phoenix Drive, Sullivan, MO 63080 | 2006-09-20 |
| 1083724116 | Sharon A Titter | Physical Therapist | 107 Progress Dr, Sullivan, MO 63080 | 2006-08-30 |
| 1437135571 | Thanh Duy Vo | Pediatrics | 486 N Church St, Sullivan, MO 63080 | 2005-12-20 |
| 1508849316 | Air Evac Ems Inc | Ambulance | 673 Sappington Bridge Rd, Sullivan, MO 63080 | 2005-11-25 |
| Find all providers in zip 63080 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323701 | Sullivan County Community Hospital | Clinic/Center | 2186 N Hospital Blvd Ste 2, Sullivan, IN 47882-7654 | 2020-07-20 |
| 1154939320 | Sullivan County Community Hospital | Clinic/Center | 2200 N Section St, Sullivan, IN 47882-7523 | 2020-07-14 |
| 1063831527 | Mso Clinics, Inc. | Clinic/Center | 2200 N Section St, Sullivan, IN 47882-7523 | 2014-04-14 |
| 1215945480 | Missouri Baptist Hospital of Sullivan | Clinic/Center | 751 Sappington Bridge Rd, Sullivan, MO 63080-2354 | 2006-08-04 |
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|---|---|---|---|---|
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| 1447873914 | 2 for Him, LLC | Clinic/Center | 310 Route 66 E, Waynesville, MO 65583-2648 | 2020-05-19 |
| 1780204586 | Keep Well Now | Clinic/Center | 2405 Aspen Rd, Highlandville, MO 65669-8051 | 2020-04-21 |
| 1871112102 | Thrive St. Louis, Inc | Clinic/Center | 4331 Lindell Blvd, Saint Louis, MO 63108-2701 | 2020-04-16 |
| 1548893530 | Gateway Direct Primary Care Jv LLC | Clinic/Center | 1015 Corporate Square Dr Ste 101, Saint Louis, MO 63132-2938 | 2020-02-18 |
| 1033741202 | Olalani Holdings LLC | Clinic/Center | 950 Francis Pl Ste 217, Clayton, MO 63105-2465 | 2020-02-06 |
| 1124659180 | Eldon Family Chiropractic, LLC | Clinic/Center | 102 N Business Highway 54 E Ste D, Eldon, MO 65026-2041 | 2020-01-29 |
| 1619518032 | Mcpherson Medical & Diagnostic, LLC | Clinic/Center | 110 Us Hwy 61 N, Ste B, Hayti, MO 63851 | 2019-10-07 |
| Find all providers with the same taxonomy | ||||
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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.