Miesha Bunn

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP012183 Issued in GA

Practice address

3776 Lavista Rd Ste 250
Tucker, GA 30084-5657

Phone

(770) 862-6447

Fax

(833) 232-1614

NPI assigned

Mar 30, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Therapy Goals LLC

  • Speech-Language Pathologist
  • Tucker, GA
  • NPI 1558906024
  NPD

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1295430361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3776 LAVISTA RD STE 250",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3776 LAVISTA RD STE 250",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845657",
            "telephone_number": "770-862-6447",
            "fax_number": "833-232-1614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNN",
        "first_name": "MIESHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-30",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP012183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith R Bruno, MD
• Nicole Fernandez Brunton
• Erica M Bryant, PHARM.D.
• John William Budell, MD
• Building Roses Health & Wellness
• Kia Elon Burch, PHYSICIAN ASSISTANT
• Vera E. Burns, O.D.
• Norman David Busch, DDS
• Business Talent Solutions LLC
• Leora E Butcher

• Speech-Language Pathologist in Tucker, GA
• Providers in Tucker, GA by specialty
• Speech-Language Pathologist in Georgia

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