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Contact Information

INNOVATIVE PEDIATRICS LLC
103 SHARON LN
GARDEN CITY, MO64747-9201
 Phone: 913-961-7514
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Early Intervention Provider Agency

252Y00000X
 

Local Education Agency (LEA)

251300000X
 

Occupational Therapist

225X00000X 67 Occupational Therapist in Private Practice
 

Occupational Therapy Assistant

224Z00000X
 

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
 

Physical Therapy Assistant

225200000X
 

Speech-Language Assistant

2355S0801X
 

Speech-Language Pathologist

235Z00000X 15 Speech Language Pathologist
Indicates primary specialty

NPI Profile & details for INNOVATIVE PEDIATRICS LLC

NPI # 1699525576
LBN Legal business name INNOVATIVE PEDIATRICS LLC
Authorized official SKYLER JACOBSON - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/25/2024
Last updated 03/25/2024 - About 2 years ago
Identifiers
MO Medicaid 1194588970
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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