MEDICARE: WEATHERS PEDIATRIC THERAPY OF SELLERSBURG LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	235Z00000X	Speech-Language Pathologist
2	2080P0006X	Developmental - Behavioral Pediatrics Physician
3	2251P0200X	Pediatric Physical Therapist

General Provider Information

NPI Number	:	1194695460
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEATHERS PEDIATRIC THERAPY OF SELLERSBURG LLC

Provider Business Mailing Address
First Line	:	227 HALCYON RD
Second Line	:
City	:	CHARLESTOWN
State	:	IN
Zip	:	47111-2045
Country	:	US
Telephone Number	:	502-436-7537
Fax Number	:

Provider Business Practice Location Address
First Line	:	326 N INDIANA AVE
Second Line	:
City	:	SELLERSBURG
State	:	IN
Zip	:	47172-1223
Country	:	US
Telephone Number	:	502-436-7537
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NASHYLA THOMAS
Credential	:
Telephone Number	:	502-436-7537

Provider Enumeration Date	:	11/10/2025
Last Update Date	:	11/10/2025

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