Active NPI
Janine Kreider, CCC-SLP
- Speech-Language Pathologist
- Darien, GA
National Provider Identifier
1174909170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 12198
- Practice address
- 300 Bridgewater Lane
Darien, GA 31305-3130 - Phone
- (912) 248-2734
- NPI assigned
- Aug 3, 2015
- Last updated
- Jul 21, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 12198 | NC | Primary |
Addresses
Primary practice location
300 Bridgewater Lane
Darien, GA 31305-3130
Mailing address
300 Bridgewater Lane
Darien, GA 31305-4700
Phone (912) 248-2734
Other practice location 1
410 New Bridge St Ste 10A
Jacksonville, NC 28540-4700
Phone (910) 347-2212
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12198 | NC | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Restorative Language Therapy Services | Current | Accepting new patients | |
| Restorative Language Therapy Services | Current | Accepting new patients | |
| Pro Step Therapy Inc | Past | Accepting new patients | |
| J.Z. Mann Pediatric Therapy, Inc. | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Home Health Agency
- Darien, GA
- NPI 1407552177
-
- Clinic/Center
- Darien, GA
- NPI 1952007544
-
- Speech-Language Pathologist
- Jacksonville, NC
- NPI 1316031222
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1174909170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 BRIDGEWATER LANE",
"city": "DARIEN",
"state": "GA",
"postal_code": "313054700",
"telephone_number": "912-248-2734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 BRIDGEWATER LANE",
"city": "DARIEN",
"state": "GA",
"postal_code": "313053130",
"telephone_number": "912-248-2734"
}
],
"practiceLocations": [
{
"address_1": "410 New Bridge St Ste 10A",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "NC",
"postal_code": "285404700",
"country_code": "US",
"telephone_number": "910-347-2212",
"fax_number": "910-338-5013",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KREIDER",
"first_name": "JANINE",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-03",
"last_updated": "2022-07-21",
"certification_date": "2022-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "12198",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Darien, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.