Provider Demographics
NPI:1770001521
Name:KW PEDS & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:KW PEDS & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/ OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERITA
Authorized Official - Middle Name:N
Authorized Official - Last Name:QUICK-WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-630-0090
Mailing Address - Street 1:1317 KING ARTHUR CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-2819
Mailing Address - Country:US
Mailing Address - Phone:757-630-9236
Mailing Address - Fax:
Practice Address - Street 1:4012 RAINTREE RD STE 100B
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-3741
Practice Address - Country:US
Practice Address - Phone:757-630-9236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-31
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty