John Lott Sandidge, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP004077 Issued in GA

Practice address

640 Glen Iris Dr NE
Unit 508
Atlanta, GA 30308-2723

Phone

(404) 277-5813

NPI assigned

Feb 4, 2011

Sex

Male

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1296777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1104122373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000",
            "address_2": "DEPT 128",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381480128",
            "telephone_number": "901-821-0338",
            "fax_number": "901-821-0341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 GLEN IRIS DR NE",
            "address_2": "UNIT 508",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082723",
            "telephone_number": "404-277-5813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDIDGE",
        "first_name": "JOHN",
        "middle_name": "LOTT",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-04",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP004077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Holt Sanders, MD
• Judy A Sanderson, PSY.D.
• Steven Bryan Sanderson, DMD
• Pratik Sandesara, M.D.
• Pavneet Sandhu, MD
• Lela Sandiford, ARNP
• Robert J. Sandler, PAAA
• Corban Sandoe, P.A.
• Abigail Elaine Sandoval Lermont, PA-C
• Mario Christopher Sandoval, MD

• Speech-Language Pathologist in Atlanta, GA
• Providers in Atlanta, 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 Mar 3, 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.

Verify at the official NPI Registry.