WILDERNESS TRACE CHILD DEVELOPMENT CENTER NPI 1003024084
Physical Therapist in Danville, KY
About WILDERNESS TRACE CHILD DEVELOPMENT CENTER
Wilderness Trace Child Development Center is a provider established in Danville, Kentucky specializing in physical therapist. The NPI number of Wilderness Trace Child Development Center is 1003024084 and was assigned on May 2007. The practitioner's primary taxonomy code is 225100000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Mrs. Libby Suttles (Executive Director)
| NPI | 1003024084 |
| Provider Name | WILDERNESS TRACE CHILD DEVELOPMENT CENTER |
| Provider Location Address | 409 STEWARTS LN N DANVILLE, KY 40422 |
| Provider Mailing Address | 409 STEWARTS LN N DANVILLE, KY 40422 |
| NPI Entity Type | Organization |
| Is Sole Proprietor? | N/A |
| Is Organization Subpart? | No |
| Enumeration Date | 05-21-2007 |
| Last Update Date | 05-10-2017 |
Primary Taxonomy
| Taxonomy Code | 225100000X |
| Classification | Physical Therapist |
| Type | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Description | Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
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Business Address
WILDERNESS TRACE CHILD DEVELOPMENT CENTER
409 STEWARTS LN N
DANVILLE, KY
ZIP 40422
Phone: (859) 236-0878
Fax: (859) 236-0878
Mailing Address
WILDERNESS TRACE CHILD DEVELOPMENT CENTER
409 STEWARTS LN N
DANVILLE, KY
ZIP 40422
Phone: (859) 236-0878
Fax: (859) 236-3570
Secondary Taxonomies
The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.
| No. | Taxonomy Code | Type | Classification | Specialization | License No. | State | Primary |
|---|---|---|---|---|---|---|---|
| 1 | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | No | |||
Taxonomy Description: an occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. | |||||||
| 2 | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | No | |||
Taxonomy Description: 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. | |||||||
| 3 | 251300000X | Agencies | Local Education Agency (LEA) | 354928 | KY | No | |
Taxonomy Description: the term local education agency means a public board of education or other public authority legally constituted within a State to either provide administrative control or direction of, or perform a service function for public schools serving individuals ages 0 - 21 in a state, city, county, township, school district, or other political subdivision including a combination of school districts or counties recognized in a State as an administrative agency for its public schools. An LEA may provide, or employ professional who provide, services to children included in the Individuals with Disabilities Education Act (IDEA), such services may include, but are not limited to, such medical services as physical, occupational, and speech therapy. | |||||||
Additional Identifiers
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State |
|---|---|---|
| 00153 | OTHER (01) | KY |
| 7100454490 | MEDICAID (05) | KY |
Other Providers at the same location
The following 6 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1093981649 | MRS. ANNA MARIE GREENE DIGGS M.A., CCC-SLP Individual | Speech-Language Pathologist | 409 STEWARTS LN N DANVILLE, KY 40422 (859) 236-0878 |
| 1235395526 | JENNIFER ASHLEY FITZHUGH Individual | Specialist | 409 STEWARTS LN N DANVILLE, KY 40422 (859) 396-9223 |
| 1952567240 | WENDY Y. LOGAN Individual | Specialist | 409 STEWARTS LN N DANVILLE, KY 40422 (859) 236-0878 |
| 1548570716 | MRS. ERIN K.S.. BERRY DPT Individual | Physical Therapist | 409 STEWARTS LN N DANVILLE, KY 40422 (859) 236-0878 |
| 1760726087 | MRS. RACHEL ELIZABETH KEY M.S. SLP Individual | Speech-Language Pathologist | 409 STEWARTS LN N DANVILLE, KY 40422 (859) 236-0878 |
| 1831737956 | KATHERINE PATTERSON MSOT, OTR/L Individual | Occupational Therapist | 409 STEWARTS LN N DANVILLE, KY 40422 (859) 236-0878 |
NPI Footnotes
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.