Provider Demographics
NPI:1386667822
Name:THE SPEECH AND HEARING CENTER
Entity Type:Organization
Organization Name:THE SPEECH AND HEARING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSTWICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-320-3834
Mailing Address - Street 1:2212 ENCOMPASS DR STE 148
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-1577
Mailing Address - Country:US
Mailing Address - Phone:423-622-6900
Mailing Address - Fax:423-622-4834
Practice Address - Street 1:2212 ENCOMPASS DR STE 148
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1577
Practice Address - Country:US
Practice Address - Phone:423-622-6900
Practice Address - Fax:423-622-4834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X, 225X00000X, 235Z00000X, 237600000X
TN1313231H00000X
GAAUD003693231H00000X
TNSP0000000667235Z00000X
GASLP001410235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2006365OtherBCBST PROVIDER ID #
TN4640001OtherUNITEDHEALTHCARE ID#
TN103G700326OtherMEDICARE
TN446509Medicare Oscar/Certification