Individual provider Active NPI

Kristin Marie Schaffer, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Kennesaw, GA
National Provider Identifier
1124380282
Registry record updated Jul 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP008541 Issued in GA
Practice address
2950 Cherokee St NW
Building 500
Kennesaw, GA 30144-6500
Phone
(678) 895-5074
Fax
(678) 903-5506
NPI assigned
Jun 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA11206 FL
Speech-Language Pathologist 235Z00000X SLP008541 GA Primary

Addresses

Primary practice location

2950 Cherokee St NW
Building 500
Kennesaw, GA 30144-6500

Mailing address

2950 Cherokee St NW
Building 500
Kennesaw, GA 30144-6500
Phone (678) 895-5074

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SA11206FLMDSpeech-Language Pathologist
SLP008541GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Child Therapy Past Accepting new patients
Speech-Language Therapy of Georgia, LLC Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405900800000",
    "number": "1124380282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 CHEROKEE ST NW",
            "address_2": "BUILDING 500",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301446500",
            "telephone_number": "678-895-5074",
            "fax_number": "678-903-5506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 CHEROKEE ST NW",
            "address_2": "BUILDING 500",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301446500",
            "telephone_number": "678-895-5074",
            "fax_number": "678-903-5506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAFFER",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2014-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA11206",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP008541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; 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.