Individual provider Active NPI

Janel Redd

  • Speech-Language Pathologist
  • Fayetteville, GA
National Provider Identifier
1154630127
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP007199 Issued in GA
Practice address
130 Howard LN
Fayetteville, GA 30215-1849
Phone
(770) 460-0165
NPI assigned
Sep 24, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP007199 GA Primary

Addresses

Primary practice location

130 Howard LN
Fayetteville, GA 30215-1849

Mailing address

130 Howard LN
Fayetteville, GA 30215-1849

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

LicenseStateTypeSpecialty
SLP007199GAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1285286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1154630127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 HOWARD LN",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302151849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 HOWARD LN",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302151849",
            "telephone_number": "770-460-0165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDD",
        "first_name": "JANEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-24",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP007199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; 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.