Kimberly Page Cooper, SLP
Individual provider Active NPI Speech-Language Pathologist · Swainsboro, GA
NPI 1104137413 · NPPES record last updated Sep 6, 2022
Key facts
- NPI
- 1104137413
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SLP007349 (GA)
- Practice address
- 1007 Ga Highway 56 S Ste a
Swainsboro, GA 30401-5328 - Phone
- (478) 237-6363
- Fax
- (478) 237-6364
- NPI assigned
- Jul 1, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP007349 | GA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Speech Teach Inc | Speech-Language Pathologist | Past | Accepting new patients |
| Cooper Speech Services LLC | Speech-Language Pathologist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP007349 | GA | Yes |
Addresses
Primary practice location
1007 Ga Highway 56 S Ste a
Swainsboro, GA 30401-5328
Mailing address
1007 Ga Highway 56 S Ste a
Swainsboro, GA 30401-5328
Phone (478) 237-6363
Other practice location 1
420 W Main St
Swainsboro, GA 30401-3105
Phone (478) 237-6363
Other practice location 2
3502 Pollett Rd
Wadley, GA 30477-3538
Phone (478) 469-3557
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 277041361B | Medicaid | GA | |
| SLP007349 | Other | GA | GA LICENSE |
Other providers in Swainsboro, GA
- Community Service Board of Middle Georgia
- Community Service Board of Middle Georgia
- Community Service Board of Middle Georgia
- Community Service Board of Middle Georgia
- William F Connor
- Janet Costley
- Debra L Crawley-Mataosky
- David W Crooke
- Crossroads Wellness PC
- Lydia Lee Daley
All providers in Swainsboro, GA · Speech-Language Pathologist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.