Individual provider Active NPI

Tracie Lynn Knauf, MA, CCC-SLP

  • Speech-Language Pathologist
  • Woodstock, GA
National Provider Identifier
1245558436
Registry record updated May 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP003451 Issued in GA
Practice address
341 Creekstone RDG
Woodstock, GA 30188-3745
Phone
(678) 462-1342
Fax
(678) 493-9464
NPI assigned
May 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2010

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 SLP003451 GA Primary

Addresses

Primary practice location

341 Creekstone RDG
Woodstock, GA 30188-3745

Mailing address

709 Crescent Cir
Canton, GA 30115-4772
Phone (678) 462-1342

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

LicenseStateTypeSpecialty
SLP003451GAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1273622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273622400000",
    "number": "1245558436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 CRESCENT CIR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301154772",
            "telephone_number": "678-462-1342",
            "fax_number": "678-493-9464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 CREEKSTONE RDG",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301883745",
            "telephone_number": "678-462-1342",
            "fax_number": "678-493-9464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNAUF",
        "first_name": "TRACIE",
        "middle_name": "LYNN",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-12",
        "last_updated": "2010-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP003451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2010; 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.