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Contact Information

MARSHALL PEDIATRIC THERAPY, LLC
109 WIND HAVEN DR STE 100
NICHOLASVILLE, KY40356-8010
 Phone: 859-224-2273
 Fax: 859-224-4675
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

225XP0200X 67 Occupational Therapist in Private Practice
 

Community/Behavioral Health

251S00000X
 

Occupational Therapist

225X00000X 67 Occupational Therapist in Private Practice
 

Physical Rehabilitation

225XP0019X 67 Occupational Therapist in Private Practice
 

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
 

Professional

101YP2500X
 

Speech-Language Pathologist

235Z00000X 15 Speech Language Pathologist
Indicates primary specialty

NPI Profile & details for MARSHALL PEDIATRIC THERAPY, LLC

NPI Number 1104198472
LBN Legal business name MARSHALL PEDIATRIC THERAPY, LLC
Authorized official PAM MARSHALL - (OCCUPATIONAL THERAPIST / OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/02/2012
Last updated 02/25/2025 - More than a year ago
Identifiers
KY License # 1196
KY License # 4077
KY License # 5326
KY License # R3083
KY Medicaid 7100205670
KY Medicaid 7100215800
KY Medicaid 7100275720
KY Medicaid 7100278210
KY Medicaid 7100299670
KY Medicaid 7100328480
KY Medicaid 7101016200
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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