Jaclyn Michelle Caserta, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP010583 Issued in GA

Practice address

2110 Moon Station Dr NW
Kennesaw, GA 30144-2759

Phone

(627) 770-2267

NPI assigned

Mar 28, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Group practices

Fox Rehabilitation Ga, LLCGroup PAC ID 6800162298, 109 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Fox Rehabilitation Ga, LLC

  • Physical Therapist
  • Atlanta, GA
  • NPI 1023544624

  Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD
• Appleseeds Learning Center, Inc.

  • Behavior Analyst
  • Kennesaw, GA
  • NPI 1215306550
  NPD (past)

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1114488434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 MOON STATION DR NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442759",
            "telephone_number": "627-770-2267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 MOON STATION DR NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442759",
            "telephone_number": "627-770-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASERTA",
        "first_name": "JACLYN",
        "middle_name": "MICHELLE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP010583",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "13415",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dametria Carson, LPC
• Alfred Ball Carter IV, MA
• Elaine Hall Carter
• Kenneth Earl Carter Jr.
• Michelle Carter, M.S. CCC-SLP
• Lisa Robbin Casey, PTA
• Natalie Ann Casey, ED.M.
• Wanda Casey, PT
• Madeline Kearns Cash, NP
• Nina Cason

• Speech-Language Pathologist in Kennesaw, GA
• Providers in Kennesaw, 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 Aug 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.