NPIMap

Allison Shannon Ganus, MCD CCC

Individual provider Active NPI Speech-Language Pathologist · Columbus, GA

NPI 1043365141 · NPPES record last updated Jun 3, 2011

Key facts

NPI
1043365141
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SLP006645 (GA)
Practice address
2424 Double Churches Rd
Columbus, GA 31909-2741
Phone
(706) 324-6112
Fax
(706) 596-8259
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SLP006645GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Speech & Hearing Center Speech-Language Pathologist Past
since May 1, 2011		 Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP006645 GA Yes

Addresses

Primary practice location

2424 Double Churches Rd
Columbus, GA 31909-2741

Mailing address

2424 Double Churches Rd
Columbus, GA 31909-2741
Phone (706) 324-6112

Other identifiers

IdentifierTypeStateIssuer
52205907OtherGABLUE CROSS BLUE SHIELD
235553474AMedicaidGA

Other names

  • Allison Ann Shannon Former name

Other providers in Columbus, GA

All providers in Columbus, GA · Speech-Language Pathologist in Georgia

Sources for this page

Verify at the official NPI Registry.