Individual provider Active NPI

Barbara Peterson, MHA, MA, CCC-SLP

  • Speech-Language Pathologist
  • Marble Hill, GA
National Provider Identifier
1003032913
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP006284 Issued in GA
Practice address
4940 Steve Tate Hwy
Marble Hill, GA 30148-2227
Phone
(678) 327-6228
NPI assigned
Apr 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP006284 GA Primary

Addresses

Primary practice location

4940 Steve Tate Hwy
Marble Hill, GA 30148-2227

Mailing address

4940 Steve Tate Hwy
Marble Hill, GA 30148-2227
Phone (678) 327-6228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210920000047 GA Practitioner - Qualified Speech Language Pathologist 9638576689 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Medical University of South Carolina College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Weston Group IncGroup PAC ID 8123936796, 215 clinicians

Practice addresses (Care Compare)

1100 Reinhardt College Pkwy
Canton, GA 30114-2011
Phone (770) 721-2812

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SLP006284GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Paxxon Healthcare Services LLC Speech-Language Pathologist CurrentSince Aug 30, 2021 Accepting new patients
Paxxon Healthcare Services LLC CurrentSince Aug 30, 2021 Accepting new patients
Empowerme Rehabilitation Georgia, LLC Speech-Language Pathologist CurrentSince Nov 29, 2022 Accepting new patients
The Weston Group Inc. CurrentSince Aug 30, 2021 Accepting new patients
The Weston Group Inc. Speech-Language Pathologist CurrentSince Aug 30, 2021 Accepting new patients
Kids Creek Therapy Speech-Language Pathologist Past Accepting new patients

Locations

2725 Holcomb Bridge Rd
Alpharetta, GA 30022
Phone (770) 649-0808

762 N Main St
Alpharetta, GA 30009
Phone (678) 268-6335

1100 Reinhardt College Pkwy
Canton, GA 30114
Phone (770) 721-2812

5610 Hampton Park Dr
Cumming, GA 30041
Phone (470) 866-5540

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 287-3917

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1003032913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4940 STEVE TATE HWY",
            "city": "MARBLE HILL",
            "state": "GA",
            "postal_code": "301482227",
            "telephone_number": "678-327-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 STEVE TATE HWY",
            "city": "MARBLE HILL",
            "state": "GA",
            "postal_code": "301482227",
            "telephone_number": "678-327-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "BARBARA",
        "credential": "MHA, MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP006284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marble Hill, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.