Active NPI
Myriam K Robinson, CCC-SLP
- Speech-Language Pathologist
- Stone Mountain, GA
National Provider Identifier
1023316965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 005420
- Practice address
- 5190 Island Dr
Stone Mountain, GA 30087-4248 - Phone
- (404) 643-6098
- Fax
- (877) 245-3717
- NPI assigned
- Mar 1, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 005420 | GA | Primary |
Addresses
Primary practice location
5190 Island Dr
Stone Mountain, GA 30087-4248
Mailing address
5190 Island Dr
Stone Mountain, GA 30087-4248
Phone (404) 643-6098
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005420 | GA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peach Speech Services, LLC | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Speech-Language Pathologist
- Stone Mountain, GA
- NPI 1194070599
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1298937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340582400000",
"number": "1023316965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5190 ISLAND DR",
"city": "STONE MOUNTAIN",
"state": "GA",
"postal_code": "300874248",
"telephone_number": "404-643-6098",
"fax_number": "877-245-3717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5190 ISLAND DR",
"city": "STONE MOUNTAIN",
"state": "GA",
"postal_code": "300874248",
"telephone_number": "404-643-6098",
"fax_number": "877-245-3717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBINSON",
"first_name": "MYRIAM",
"middle_name": "K",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-01",
"last_updated": "2012-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "005420",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stone Mountain, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.