Active NPI
Alexis D Chambliss, SPEECH-LANGUAGE
- Speech-Language Pathologist
- Byron, GA
National Provider Identifier
1194151431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP008017
- Practice address
- 100 Hamilton Pointe Dr
115 & 120
Byron, GA 31008 - Phone
- (478) 538-1436
- Fax
- (478) 474-6601
- NPI assigned
- Sep 18, 2013
- Last updated
- Sep 18, 2013
- 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 | SLP008017 | GA | Primary |
Addresses
Primary practice location
100 Hamilton Pointe Dr
115 & 120
Byron, GA 31008
Mailing address
100 Hamilton Pointe Dr
Suite 115 & 120
Byron, GA 31008
Phone (478) 538-1436
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
| License | State | Type | Specialty |
|---|---|---|---|
| SLP008017 | GA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Middle Georgia Family Rehab | Past | Accepting new patients | |
| Middle Georgia Family Rehab | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Byron, GA
- NPI 1245672724
-
- Health Maintenance Organization
- Byron, GA
- NPI 1366844367
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379462400000",
"number": "1194151431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 HAMILTON POINTE DR",
"address_2": "SUITE 115 & 120",
"city": "BYRON",
"state": "GA",
"postal_code": "31008",
"telephone_number": "478-538-1436",
"fax_number": "478-474-6601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 HAMILTON POINTE DR",
"address_2": "115 & 120",
"city": "BYRON",
"state": "GA",
"postal_code": "31008",
"telephone_number": "478-538-1436",
"fax_number": "478-474-6601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAMBLISS",
"first_name": "ALEXIS",
"middle_name": "D",
"credential": "SPEECH-LANGUAGE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-18",
"last_updated": "2013-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "SLP008017",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Byron, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.