Individual provider Active NPI

Rachel B Duke, M.ED. CCCSLP

  • Speech-Language Pathologist
  • Lawrenceville, GA
National Provider Identifier
1073004677
Registry record updated Jul 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP010191 Issued in GA
Practice address
545 Old Norcross Rd Ste 200
Lawrenceville, GA 30046
Phone
(678) 377-2833
Fax
(678) 502-7800
NPI assigned
May 20, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2018

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 SLP010191 GA Primary

Addresses

Primary practice location

545 Old Norcross Rd Ste 200
Lawrenceville, GA 30046

Mailing address

107B Deer TRL NE
Milledgeville, GA 31061-8716
Phone (478) 414-8876

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 Education

State licenses

LicenseStateTypeSpecialty
SLP010191GAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1526774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531699200000",
    "number": "1073004677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107B DEER TRL NE",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310618716",
            "telephone_number": "478-414-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 OLD NORCROSS RD STE 200",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "30046",
            "telephone_number": "678-377-2833",
            "fax_number": "678-502-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUKE",
        "first_name": "RACHEL",
        "middle_name": "B",
        "credential": "M.ED. CCCSLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-20",
        "last_updated": "2018-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP010191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2018; 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.