Individual provider Active NPI

Yashaira Hernandez-Rosado

  • Speech-Language Pathologist
  • Atlanta, GA
National Provider Identifier
1053962316
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP009830 Issued in GA
Practice address
5287 Barrington Trace Dr SW
Atlanta, GA 30331-7898
Phone
(812) 204-7696
Fax
(404) 344-2502
NPI assigned
Sep 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP009830 GA Primary

Addresses

Primary practice location

5287 Barrington Trace Dr SW
Atlanta, GA 30331-7898

Mailing address

5287 Barrington Trace Dr SW
Atlanta, GA 30331-7898
Phone (812) 204-7696

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

LicenseStateTypeSpecialty
SLP009830GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Changing Lives 2Gether LLC Speech-Language Pathologist CurrentSince Sep 29, 2019 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.

NPI Registry JSON

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1053962316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5287 BARRINGTON TRACE DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303317898",
            "telephone_number": "812-204-7696",
            "fax_number": "404-344-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5287 BARRINGTON TRACE DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303317898",
            "telephone_number": "812-204-7696",
            "fax_number": "404-344-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ-ROSADO",
        "first_name": "YASHAIRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-26",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP009830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; 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.