Peach Speech Services, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

005420 Issued in GA

Legal business name

PEACH SPEECH SERVICES, LLC

Practice address

5190 Island Dr
Stone Mountain, GA 30087-4248

Phone

(404) 643-6098

Fax

(877) 245-3717

NPI assigned

Jul 23, 2012

Organization subpart

No

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

Authorized official

Name

Myriam Katrina Robinson, M.ED., CCC-SLPNPI 1023316965

Title

Owner

Phone

(404) 643-6098

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Myriam K Robinson, CCC-SLP

  • Speech-Language Pathologist
  • Stone Mountain, GA
  • NPI 1023316965
  NPD (past) Authorized official

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343001600000",
    "number": "1194070599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5190 ISLAND DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300874248",
            "telephone_number": "404-643-6098",
            "fax_number": "877-245-3717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5190 ISLAND DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300874248",
            "telephone_number": "404-643-6098",
            "fax_number": "877-245-3717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH SPEECH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-23",
        "last_updated": "2012-07-23",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "MYRIAM",
        "authorized_official_middle_name": "KATRINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-643-6098",
        "authorized_official_credential": "M.ED., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "005420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003122698A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Stone Mountain, GA
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; 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.