Active NPI
Jennifer A.R. Mitchell, M.S. SLP
- Speech-Language Pathologist
- Buford, GA
National Provider Identifier
1063748606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- P-0433
- Practice address
- 2140 Buford Hwy Ste 109
Buford, GA 30518-6121 - Phone
- (174) 247-0589
- NPI assigned
- Nov 1, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | P-0433 | NH | Primary |
Addresses
Primary practice location
2140 Buford Hwy Ste 109
Buford, GA 30518-6121
Mailing address
905 Yosemite Dr
Suwanee, GA 30024-4031
Phone (603) 793-3813
Other practice location 1
4055 Johns Creek Pkwy Ste A
Suwanee, GA 30024-1299
Phone (770) 888-5221
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P-0433 | NH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680480000000",
"number": "1063748606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905 YOSEMITE DR",
"city": "SUWANEE",
"state": "GA",
"postal_code": "300244031",
"telephone_number": "603-793-3813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2140 BUFORD HWY STE 109",
"city": "BUFORD",
"state": "GA",
"postal_code": "305186121",
"telephone_number": "174-247-0589"
}
],
"practiceLocations": [
{
"address_1": "4055 Johns Creek Pkwy Ste A",
"address_purpose": "LOCATION",
"city": "Suwanee",
"state": "GA",
"postal_code": "300241299",
"country_code": "US",
"telephone_number": "770-888-5221",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MITCHELL",
"first_name": "JENNIFER",
"middle_name": "A.R.",
"name_prefix": "Miss",
"credential": "M.S. SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-01",
"last_updated": "2023-04-03",
"certification_date": "2023-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NH",
"license": "P-0433",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buford, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.