Active NPI
Maria Cyriac, MS, CCC-SLP
- Speech-Language Pathologist
- Marietta, GA
National Provider Identifier
1083847255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP012098
- Practice address
- 4267 Springmill Dr
Marietta, GA 30062-1174 - Phone
- (818) 357-7020
- NPI assigned
- Sep 3, 2009
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 41YS00602000 | NJ | |
| Speech-Language Pathologist | 235Z00000X | SP15513 | CA | |
| Speech-Language Pathologist | 235Z00000X | SLP012098 | GA | Primary |
Addresses
Primary practice location
4267 Springmill Dr
Marietta, GA 30062-1174
Mailing address
4267 Springmill Dr
Marietta, GA 30062-1174
Phone (818) 357-7020
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP15513 | CA | MD | Speech-Language Pathologist |
| SLP012098 | GA | MD | Speech-Language Pathologist |
| 41YS00602000 | NJ | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708992000000",
"number": "1083847255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4267 SPRINGMILL DR",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300621174",
"telephone_number": "818-357-7020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4267 SPRINGMILL DR",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300621174",
"telephone_number": "818-357-7020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CYRIAC",
"first_name": "MARIA",
"credential": "MS, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-09-03",
"last_updated": "2024-02-27",
"certification_date": "2024-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NJ",
"license": "41YS00602000",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "SP15513",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "SLP012098",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "The Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "280 Hospital Pkwy",
"city": "San Jose",
"state": "CA",
"country_code": "US",
"postal_code": "95119",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.