Active NPI
Laterrian Marie Robinson, M.S., CCC-SLP
- Speech-Language Pathologist
- Conyers, GA
National Provider Identifier
1063778710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP007761
- Practice address
- 2395 Wall St SE
Ste 170
Conyers, GA 30013-6703 - Phone
- (205) 602-2337
- NPI assigned
- Apr 6, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 | SLP007761 | GA | Primary |
Addresses
Primary practice location
2395 Wall St SE
Ste 170
Conyers, GA 30013-6703
Mailing address
115 Bowen Way
Covington, GA 30016-3434
Phone (205) 602-2337
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003123817B | Medicaid | GA |
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 |
|---|---|---|---|
| SLP007761 | GA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Communication Corner, LLC | Speech-Language Pathologist | Current | Accepting new patients |
| Kids Speech and OT | Speech-Language Pathologist | Current | Accepting new patients |
Organizations & group practices 2
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.
-
- Speech-Language Pathologist
- Conyers, GA
- NPI 1790255610
-
- Speech-Language Pathologist
- Conyers, GA
- NPI 1366066714
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472083200000",
"number": "1063778710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 BOWEN WAY",
"city": "COVINGTON",
"state": "GA",
"postal_code": "300163434",
"telephone_number": "205-602-2337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2395 WALL ST SE",
"address_2": "STE 170",
"city": "CONYERS",
"state": "GA",
"postal_code": "300136703",
"telephone_number": "205-602-2337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBINSON",
"first_name": "LATERRIAN",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-04-06",
"last_updated": "2016-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "SLP007761",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003123817B",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Conyers, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.