Individual provider Active NPI

Nicole Horner

  • Speech-Language Pathologist
  • Saint Marys, GA
National Provider Identifier
1245923945
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
PCET003787 Issued in GA
Practice address
2015 Osborne Rd Ste a
Saint Marys, GA 31558-9164
Phone
(912) 576-9603
Fax
(912) 576-9865
NPI assigned
May 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2023

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 PCET003787 GA Primary

Addresses

Primary practice location

2015 Osborne Rd Ste a
Saint Marys, GA 31558-9164

Mailing address

2015 Osborne Rd Ste a
Saint Marys, GA 31558-9164
Phone (912) 576-9603

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
PCET003787GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Crew Speech & Language Group, Inc Speech-Language Pathologist PastSince Jun 4, 2023 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": "1685404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1245923945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 OSBORNE RD STE A",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315589164",
            "telephone_number": "912-576-9603",
            "fax_number": "912-576-9865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 OSBORNE RD STE A",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315589164",
            "telephone_number": "912-576-9603",
            "fax_number": "912-576-9865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORNER",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-30",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "PCET003787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Marys, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.

Verify at the official NPI Registry.