Active NPI
Alexis Holman, MA, CCC-SLP
- Speech-Language Pathologist
- Martinez, GA
National Provider Identifier
1215099569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7754
- Practice address
- 3724 Pebble Beach Drive
Martinez, GA 30907 - Phone
- (404) 694-4735
- NPI assigned
- Dec 14, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 7754 | NC | Primary |
Addresses
Primary practice location
3724 Pebble Beach Drive
Martinez, GA 30907
Mailing address
P.O. Box 420993
Atlanta, GA 30342
Phone (404) 694-4735
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7412768 | Medicaid | NC | |
| 146CE | Other | NC | BCBS |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7754 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324512000000",
"number": "1215099569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 420993",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30342",
"telephone_number": "404-694-4735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3724 PEBBLE BEACH DRIVE",
"city": "MARTINEZ",
"state": "GA",
"postal_code": "30907",
"telephone_number": "404-694-4735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMAN",
"first_name": "ALEXIS",
"credential": "MA, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-14",
"last_updated": "2011-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "7754",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7412768",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "146CE",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Martinez, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.