Martin Medical SLP LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

MARTIN MEDICAL SLP LLC

Practice address

103 Due West Pass
Dallas, GA 30157-2545

Phone

(404) 556-7053

NPI assigned

Oct 22, 2020

Organization subpart

No

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

Authorized official

Name

Charlene Samone Martin, M.S. CCC-SLP

Title

Speech Language Pathologist

Phone

(404) 556-7053

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603324800000",
    "number": "1114526811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 DUE WEST PASS",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301572545",
            "telephone_number": "404-556-7053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 DUE WEST PASS",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301572545",
            "telephone_number": "404-556-7053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN MEDICAL SLP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-22",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_middle_name": "SAMONE",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "404-556-7053",
        "authorized_official_credential": "M.S. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL AFFILIATION",
            "identifier": "10005249",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1417565532",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSURE",
            "identifier": "SLP007542",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "martinmedicalslp@gmail.com",
            "affiliation": "N",
            "endpointDescription": "patient information",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Healthcare information",
            "address_1": "103 Due West Pass",
            "city": "Dallas",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301572545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cynthia Macfarlane, D.C.
• Sean Macko
• Manuel Physical Therapy and Sports Performance
• Rolando E. Manuel Jr.
• Paola Marquez
• Charlene Samone Martin, M.S. CCC-SLP
• Jenny Martin, OT
• Mary Alexander Counseling LLC
• Amy Mason, SLP
• Rose Katie Massenat

• Speech-Language Pathologist in Dallas, GA
• Providers in Dallas, 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 Oct 22, 2020; 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.