Theofanis Pantazis, MS CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP006935 Issued in GA

Practice address

141 Futral Rd
Griffin, GA 30224-7455

Phone

(770) 229-5511

Fax

(770) 233-0995

NPI assigned

Jan 29, 2010

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Stepping Stones Educational Therapy Center

  • Occupational Therapist
  • Griffin, GA
  • NPI 1770774655

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1264723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264723200000",
    "number": "1093046187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 FUTRAL RD",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302247455",
            "telephone_number": "770-229-5511",
            "fax_number": "770-233-0995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 FUTRAL RD",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302247455",
            "telephone_number": "770-229-5511",
            "fax_number": "770-233-0995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTAZIS",
        "first_name": "THEOFANIS",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-29",
        "last_updated": "2010-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP006935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haritha Pabbathi, MD
• Landon Pack, PT
• Pai Participant 11 PC
• Pain Management Specialists of Atlanta P C
• Pain Management Specialists of Atlanta, PC
• Allison Danielle Parker, FNP
• Angela Parker
• Edward M. Parker Jr., DDS
• Chandra Parks, REGISTERED NURSE
• Akshar Y Patel, MD

• Speech-Language Pathologist in Griffin, GA
• Providers in Griffin, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2010; 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.