Active NPI
Leila M Serrano
- Speech-Language Pathologist
- Powder Springs, GA
National Provider Identifier
1114306370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP008865
- Practice address
- 5041 Dallas Hwy
Powder Springs, GA 30127-6458 - Phone
- (678) 305-9200
- NPI assigned
- May 21, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP008865 | GA | Primary |
Addresses
Primary practice location
5041 Dallas Hwy
Powder Springs, GA 30127-6458
Mailing address
5230 Brownwood Dr
Powder Springs, GA 30127-4715
Phone (770) 371-0616
Other practice location 1
650 S Central Ave Unit 82581
Hapeville, GA 30354-2098
Phone (678) 948-6632
Other practice location 2
5230 Brownwood Dr
Powder Springs, GA 30127-4715
Phone (770) 371-0616
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP008865 | GA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atlanta Pediatric Therapy, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Early Intervention Provider Agency
- Chamblee, GA
- NPI 1578622593
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684195200000",
"number": "1114306370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5230 BROWNWOOD DR",
"city": "POWDER SPRINGS",
"state": "GA",
"postal_code": "301274715",
"telephone_number": "770-371-0616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5041 DALLAS HWY",
"city": "POWDER SPRINGS",
"state": "GA",
"postal_code": "301276458",
"telephone_number": "678-305-9200"
}
],
"practiceLocations": [
{
"address_1": "650 S Central Ave Unit 82581",
"address_purpose": "LOCATION",
"city": "Hapeville",
"state": "GA",
"postal_code": "303542098",
"country_code": "US",
"telephone_number": "678-948-6632",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5230 Brownwood Dr",
"address_purpose": "LOCATION",
"city": "Powder Springs",
"state": "GA",
"postal_code": "301274715",
"country_code": "US",
"telephone_number": "770-371-0616",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SERRANO",
"first_name": "LEILA",
"middle_name": "M",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-05-21",
"last_updated": "2023-05-16",
"certification_date": "2023-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "SLP008865",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Powder Springs, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.