NPIMap

Organization Active NPI

Abc Pediatric Therapy Services, Inc.

  • Speech-Language Pathologist
  • Marietta, GA
National Provider Identifier
1053477265
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
572 Issued in GA
Legal business name
ABC PEDIATRIC THERAPY SERVICES, INC.
Practice address
2655 Dallas Hwy SW
Suite 320
Marietta, GA 30064-2597
Phone
(404) 556-5554
Fax
(770) 428-2112
NPI assigned
Dec 29, 2006
Last updated
Apr 8, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Authorized official

Name
Betsy Lynn Eager-Kessel, MS CCC SLPNPI 1376602672
Title
Speech Pathologist
Phone
(404) 556-5554

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
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 572 GA Primary

Addresses

Primary practice location

2655 Dallas Hwy SW
Suite 320
Marietta, GA 30064-2597

Mailing address

2655 Dallas Hwy SW
Suite 320
Marietta, GA 30064-2597
Phone (404) 556-5554

Other identifiers 1

IdentifierTypeStateIssuer
00609056HMedicaidGA

National Provider Directory

National Provider Directory

Locations

2655 Dallas Hwy SW
Ste 320
Marietta, GA 30064
Phone (404) 556-5554

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1053477265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 DALLAS HWY SW",
            "address_2": "SUITE 320",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300642597",
            "telephone_number": "404-556-5554",
            "fax_number": "770-428-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 DALLAS HWY SW",
            "address_2": "SUITE 320",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300642597",
            "telephone_number": "404-556-5554",
            "fax_number": "770-428-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABC PEDIATRIC THERAPY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-29",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "EAGER-KESSEL",
        "authorized_official_first_name": "BETSY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "SPEECH PATHOLOGIST",
        "authorized_official_telephone_number": "404-556-5554",
        "authorized_official_credential": "MS CCC SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00609056H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.