The Speech Path of Statesboro, PC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP005237 Issued in GA

Legal business name

THE SPEECH PATH OF STATESBORO, PC

Practice address

109 S Zetterower Ave
Statesboro, GA 30458-4898

Phone

(912) 489-1258

Fax

(912) 764-7006

NPI assigned

May 20, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Caroline Bowman, SLP

Title

Owner

Phone

(912) 489-1258

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1013174721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1605",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304591605",
            "telephone_number": "912-489-1258",
            "fax_number": "912-764-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 S ZETTEROWER AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584898",
            "telephone_number": "912-489-1258",
            "fax_number": "912-764-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SPEECH PATH OF STATESBORO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-489-1258",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP005237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Statesboro, GA
• Providers in Statesboro, 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 May 20, 2008; 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.