Active NPI
Sydney Moore, MCD, CCC-SLP
- Speech-Language Pathologist
- McDonough, GA
National Provider Identifier
1225716897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP012501
- Practice address
- 374 Racetrack Rd
McDonough, GA 30252-1022 - Phone
- (678) 205-5437
- NPI assigned
- Jul 5, 2023
- 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 | SLP012501 | GA | Primary |
Addresses
Primary practice location
374 Racetrack Rd
McDonough, GA 30252-1022
Mailing address
262 Royal CT
Jackson, GA 30233-7007
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 |
|---|---|---|---|
| SLP012501 | GA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kidsplay Therapy Center, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Specialist
- Loganville, GA
- NPI 1619054319
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688515200000",
"number": "1225716897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "262 ROYAL CT",
"city": "JACKSON",
"state": "GA",
"postal_code": "302337007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "374 RACETRACK RD",
"city": "MCDONOUGH",
"state": "GA",
"postal_code": "302521022",
"telephone_number": "678-205-5437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "SYDNEY",
"credential": "MCD, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-05",
"last_updated": "2023-07-05",
"certification_date": "2023-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "SLP012501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McDonough, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.