NPIMap

Individual provider Active NPI

Susan Carreker Daughtry, MCD,CCC-SLP

  • Speech-Language Pathologist
  • Kathleen, GA
National Provider Identifier
1255517967
Registry record updated Jan 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP001471 Issued in GA
Practice address
105 Tamie CT
Kathleen, GA 31047-2222
Phone
(478) 397-7886
Fax
(478) 218-2715
NPI assigned
Jan 11, 2008
Last updated
Jan 11, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2008

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 SLP001471 GA Primary

Addresses

Primary practice location

105 Tamie CT
Kathleen, GA 31047-2222

Mailing address

105 Tamie CT
Kathleen, GA 31047-2222
Phone (478) 397-7886

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
SLP001471GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speech and Language Associates, LLC 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200009600000",
    "number": "1255517967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 TAMIE CT",
            "city": "KATHLEEN",
            "state": "GA",
            "postal_code": "310472222",
            "telephone_number": "478-397-7886",
            "fax_number": "478-218-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 TAMIE CT",
            "city": "KATHLEEN",
            "state": "GA",
            "postal_code": "310472222",
            "telephone_number": "478-397-7886",
            "fax_number": "478-218-2715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHTRY",
        "first_name": "SUSAN",
        "middle_name": "CARREKER",
        "name_prefix": "Mrs.",
        "credential": "MCD,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-11",
        "last_updated": "2008-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP001471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kathleen, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; 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.