Raven Samone Watkins

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLPA000313 Issued in GA

Practice address

2537 Oakleaf RDG
Lithonia, GA 30058-6638

Phone

(205) 499-5837

NPI assigned

May 24, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1154812261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 STEVENS ENTRY",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691325",
            "telephone_number": "678-619-0178",
            "fax_number": "678-701-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2537 OAKLEAF RDG",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300586638",
            "telephone_number": "205-499-5837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "RAVEN",
        "middle_name": "SAMONE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-24",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLPA000313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Attalla Ward
• Sharon L Washington, RN
• Yolanda Washington
• Clyde Watkins Jr., MD, FACP
• Iesha Watkins
• Veronica A Watkins
• Tawanda L Watson
• We Are One Group Home LLC
• Ann M Weathersby, CNM
• Nekia Weaver

• Speech-Language Pathologist in Lithonia, GA
• Providers in Lithonia, 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 May 24, 2018; 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.