Organization Active NPI

Kids Speech and OT

  • Speech-Language Pathologist
  • Conyers, GA
National Provider Identifier
1366066714
Registry record updated Jun 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
KIDS SPEECH AND OT
Practice address
2395 Wall St SE Ste 290
Conyers, GA 30013-6703
Phone
(205) 602-2337
NPI assigned
Jun 2, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2020

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

Authorized official

Name
Laterrian RobinsonNPI 1063778710
Title
Ceo/Owner
Phone
(205) 602-2337

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

2395 Wall St SE Ste 290
Conyers, GA 30013-6703

Mailing address

2395 Wall St SE Ste 290
Conyers, GA 30013-6703

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Kidsspeech.ot2395@gmail.com

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591056000000",
    "number": "1366066714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2395 WALL ST SE STE 290",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2395 WALL ST SE STE 290",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136703",
            "telephone_number": "205-602-2337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS SPEECH AND OT",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-02",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "LATERRIAN",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "205-602-2337"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Kidsspeech.ot2395@gmail.com",
            "affiliation": "N",
            "address_1": "2395 Wall St SE Ste 290",
            "city": "Conyers",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300136703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2020; 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.