NPIMap

Organization Active NPI

Stacey Busboom Speech Therapy LLC

  • Hearing and Speech Clinic/Center
  • Monroe, GA
National Provider Identifier
1043086523
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X
Legal business name
STACEY BUSBOOM SPEECH THERAPY LLC
Practice address
4535 Chandler CT
Monroe, GA 30656-3688
Phone
(770) 625-0029
NPI assigned
Nov 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Stacey Ann Busboom, CCC-SLPNPI 1295971612
Title
Speech-Language Pathologist
Phone
(770) 625-0029

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
Hearing and Speech Clinic/Center 261QH0700X Primary

Addresses

Primary practice location

4535 Chandler CT
Monroe, GA 30656-3688

Mailing address

4535 Chandler CT
Monroe, GA 30656-3688
Phone (770) 625-0029

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1043086523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 CHANDLER CT",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306563688",
            "telephone_number": "770-625-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4535 CHANDLER CT",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306563688",
            "telephone_number": "770-625-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACEY BUSBOOM SPEECH THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "BUSBOOM",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "770-625-0029",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.