Individual provider Active NPI

Jennifer Katheran Barnes, MA

  • Speech-Language Pathologist
  • Norcross, GA
National Provider Identifier
1093019242
Registry record updated Jan 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP005620 Issued in GA
Practice address
4028 Holcomb Bridge Rd Ste 202
Norcross, GA 30092-4600
Phone
(770) 209-9826
Fax
(770) 209-9876
NPI assigned
Jan 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2011

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 SLP005620 GA Primary

Addresses

Primary practice location

4028 Holcomb Bridge Rd Ste 202
Norcross, GA 30092-4600

Mailing address

4028 Holcomb Bridge Rd Ste 202
Norcross, GA 30092-4600
Phone (770) 209-9826

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 Arts

State licenses

LicenseStateTypeSpecialty
SLP005620GAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1294012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294012800000",
    "number": "1093019242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4028 HOLCOMB BRIDGE RD STE 202",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300924600",
            "telephone_number": "770-209-9826",
            "fax_number": "770-209-9876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4028 HOLCOMB BRIDGE RD STE 202",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300924600",
            "telephone_number": "770-209-9826",
            "fax_number": "770-209-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNES",
        "first_name": "JENNIFER",
        "middle_name": "KATHERAN",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-03",
        "last_updated": "2011-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP005620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2011; 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.