=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669358677
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ELEVATE PEDIATRIC THERAPY, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/14/2025
-----------------------------------------------------
Last Update Date | 08/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6981 HIGHWAY 13
-----------------------------------------------------
City | ERIN
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37061-4465
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 931-217-7571
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 420 IEMAY RD
-----------------------------------------------------
City | ERIN
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37061-4841
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 931-217-7571
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CO-OWNER/SLP
-----------------------------------------------------
Name | KAITLYN LOWE
-----------------------------------------------------
Credential | M.S., CCC-SLP
-----------------------------------------------------
Telephone | 931-217-7571
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------