Individual provider Active NPI

Sara Beth Bryan Tanjuatco, M.S, CCC-SLP

  • Speech-Language Pathologist
  • Snellville, GA
National Provider Identifier
1235312349
Registry record updated Dec 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP005498 Issued in GA
Practice address
2314 Mossy Branch Dr
Snellville, GA 30078-7774
Phone
(770) 401-6031
Fax
(770) 982-4418
NPI assigned
Dec 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP005498 GA Primary

Addresses

Primary practice location

2314 Mossy Branch Dr
Snellville, GA 30078-7774

Mailing address

2314 Mossy Branch Dr
Snellville, GA 30078-7774
Phone (770) 401-6031

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 Science

State licenses

LicenseStateTypeSpecialty
SLP005498GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Team Speech, LLC Speech-Language Pathologist 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.

NPI Registry JSON

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1235312349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 MOSSY BRANCH DR",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300787774",
            "telephone_number": "770-401-6031",
            "fax_number": "770-982-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2314 MOSSY BRANCH DR",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300787774",
            "telephone_number": "770-401-6031",
            "fax_number": "770-982-4418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANJUATCO",
        "first_name": "SARA BETH",
        "middle_name": "BRYAN",
        "name_prefix": "Mrs.",
        "credential": "M.S, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-11",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP005498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; 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.