Amy Jo Coleman-Perryman

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP008019 Issued in GA

Practice address

331 Sawyer Meadow PL
Grayson, GA 30017-4370

Phone

(678) 825-5750

Fax

(678) 695-6050

NPI assigned

Aug 17, 2010

Last updated

Apr 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Speech Spa, LLC.

  • Early Intervention Provider Agency
  • Tucker, GA
  • NPI 1306241450
  Authorized official Same address or phone

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

{
    "created_epoch": "1282003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1003121740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 GRAYSON HWY STE 8-155",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "300171245",
            "telephone_number": "678-825-5750",
            "fax_number": "678-695-6050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 SAWYER MEADOW PL",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "300174370",
            "telephone_number": "678-825-5750",
            "fax_number": "678-695-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN-PERRYMAN",
        "first_name": "AMY",
        "middle_name": "JO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-17",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "10251",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP008019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Grayson, GA
• Providers in Grayson, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.