Healthcare Provider Details

I. General information

NPI: 1225595598
Provider Name (Legal Business Name): PIKE PEDIATRIC THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2019
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 HIGHWAY 231 S
TROY AL
36081-3058
US

IV. Provider business mailing address

200 SHILOH RD
TROY AL
36081-2414
US

V. Phone/Fax

Practice location:
  • Phone: 334-600-4055
  • Fax: 334-647-2900
Mailing address:
  • Phone: 334-268-3379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: ALEXANDRIA G SHAVER
Title or Position: OWNER/SLP
Credential: CCC-SLP
Phone: 334-600-4055