Individual provider Active NPI

Michele McCorkle, SLP

  • Speech-Language Pathologist
  • Atlanta, GA
National Provider Identifier
1205119179
Registry record updated Oct 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202010400 Issued in VA
Practice address
6600 Peachtree Dunwoody Rd NE
Building 400 , Suite 125
Atlanta, GA 30328-6773
Phone
(770) 225-8421
Fax
(678) 587-9993
NPI assigned
Sep 27, 2011
Last updated
Oct 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2341 TN
Speech-Language Pathologist 235Z00000X 2202010400 VA Primary

Addresses

Primary practice location

6600 Peachtree Dunwoody Rd NE
Building 400 , Suite 125
Atlanta, GA 30328-6773

Mailing address

1514 Chamberlain Ave
Chattanooga, TN 37404-2911
Phone (423) 304-6478

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
2202010400VAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665273600000",
    "number": "1205119179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 CHAMBERLAIN AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374042911",
            "telephone_number": "423-304-6478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 PEACHTREE DUNWOODY RD NE",
            "address_2": "BUILDING 400 , SUITE 125",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303286773",
            "telephone_number": "770-225-8421",
            "fax_number": "678-587-9993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORKLE",
        "first_name": "MICHELE",
        "name_prefix": "Ms.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-27",
        "last_updated": "2022-10-09",
        "certification_date": "2022-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "2341",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202010400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.