Kuantara Shorell Ingram, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP011098 Issued in GA

Practice address

5373 Thompson Mill Rd
Hoschton, GA 30548-4037

Phone

(770) 965-7003

NPI assigned

Jul 24, 2020

Last updated

Jul 24, 2020By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Curated Therapy Services, LLC

  • Multi-Specialty Clinic/Center
  • Lawrenceville, GA
  • NPI 1922798495

  Speech-Language Pathologist

  NPD Authorized official

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

{
    "created_epoch": "1595548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1023627213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 SWEETWATER RD APT 3202",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300448511",
            "telephone_number": "334-296-5421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5373 THOMPSON MILL RD",
            "city": "HOSCHTON",
            "state": "GA",
            "postal_code": "305484037",
            "telephone_number": "770-965-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "KUANTARA",
        "middle_name": "SHORELL",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-24",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP011098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ricky Mel Hunter, PTA
• Francine Ichim, MS, RD, LD
• Julie Immonen, CSFA
• Independent Physical Therapy of Ga, LLC
• Independent Physical Therapy of Georgia, LLC (Benchmark Physical Therapy)
• Integrated Institute of Health and Wellness (Gray Matter Wellness Center)
• Jas Links Healthcare Services Inc
• Yettel Santana Jimenez, MA,LPC
• David Johns
• Johnson's Hometown Pharmacy Inc (Johnson's River Place Pharmacy)

• Speech-Language Pathologist in Hoschton, GA
• Providers in Hoschton, 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 Jul 24, 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.