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1801145628

NPI Code Detail

MEDICARE: ON THE MOVE PEDATRIC THERAPY PLLC

MEDICARE: ON THE MOVE PEDATRIC THERAPY PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist
2	235Z00000X	Speech-Language Pathologist
3	103K00000X	Behavior Analyst
4	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801145628
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ON THE MOVE PEDATRIC THERAPY PLLC

Provider Business Mailing Address
First Line	:	2520 REGENCY RD
Second Line	:	SUITE 150
City	:	LEXINGTON
State	:	KY
Zip	:	40503-2921
Country	:	US
Telephone Number	:	859-224-0834
Fax Number	:	859-224-0882

Provider Business Practice Location Address
First Line	:	2520 REGENCY RD
Second Line	:	SUITE 150
City	:	LEXINGTON
State	:	KY
Zip	:	40503-2921
Country	:	US
Telephone Number	:	859-224-0834
Fax Number	:	859-224-0882

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. CARLA BARROWMAN CLEVENGER
Credential	:
Telephone Number	:	859-224-0834

Provider Enumeration Date	:	09/07/2012
Last Update Date	:	11/07/2016

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Directions to “ON THE MOVE PEDATRIC THERAPY PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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