The Atlanta Medical Speech Pathology Group

Primary specialty

Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X

Legal business name

THE ATLANTA MEDICAL SPEECH PATHOLOGY GROUP

Practice address

1568 Spring Hollow Way
Stone Mountain, GA 30083-1333

Phone

(678) 654-1869

NPI assigned

Jun 1, 2021

Organization subpart

No

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

Authorized official

Name

Jillian Paige HicksNPI 1740639350

Title

Owner, Speech Pathologist

Phone

(678) 654-1869

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jillian Hicks

  • Speech-Language Pathologist
  • Stone Mountain, GA
  • NPI 1740639350
  NPD Authorized official

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

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622505600000",
    "number": "1265008106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1568 SPRING HOLLOW WAY",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300831333",
            "telephone_number": "678-654-1869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1568 SPRING HOLLOW WAY",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300831333",
            "telephone_number": "678-654-1869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ATLANTA MEDICAL SPEECH PATHOLOGY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-01",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "JILLIAN",
        "authorized_official_middle_name": "PAIGE",
        "authorized_official_title_or_position": "OWNER, SPEECH PATHOLOGIST",
        "authorized_official_telephone_number": "678-654-1869"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hearing and Speech Clinic/Center in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Hearing and Speech Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; 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.