NPIMap

Organization Active NPI

Northeast Georgia Speech Center, Inc.

  • Speech-Language Pathologist
  • Gainesville, GA
National Provider Identifier
1013088715
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP000303 Issued in GA
Legal business name
NORTHEAST GEORGIA SPEECH CENTER, INC.
Practice address
621 Spring St SE
Gainesville, GA 30501-3741
Phone
(770) 534-5141
Fax
(770) 534-5141
NPI assigned
Nov 13, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Diane Brower, CCC-SLPNPI 1700308285
Title
Exec. Director
Phone
(770) 534-5141

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP000303 GA Primary

Addresses

Primary practice location

621 Spring St SE
Gainesville, GA 30501-3741

Mailing address

PO Box 1482
Gainesville, GA 30503-1482
Phone (770) 534-5141

National Provider Directory

National Provider Directory

Locations

604 Washington St NW
Ste B2
Gainesville, GA 30501
Phone (770) 462-9810

621 Spring St SE
Gainesville, GA 30501
Phone (770) 534-5141

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013088715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1482",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305031482",
            "telephone_number": "770-534-5141",
            "fax_number": "770-534-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 SPRING ST SE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013741",
            "telephone_number": "770-534-5141",
            "fax_number": "770-534-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST GEORGIA SPEECH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROWER",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "EXEC. DIRECTOR",
        "authorized_official_telephone_number": "770-534-5141",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP000303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.