Individual provider Active NPI

Mackenzie Nell Reid

  • Speech-Language Pathologist
  • Pooler, GA
National Provider Identifier
1366241788
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
PCET004185 Issued in GA
Practice address
110 Pipemakers Cir Ste 115
Pooler, GA 31322-4168
Phone
(912) 988-1526
Fax
(912) 988-1537
NPI assigned
Mar 10, 2025
Last updated
Mar 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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 PCET004185 GA Primary

Addresses

Primary practice location

110 Pipemakers Cir Ste 115
Pooler, GA 31322-4168

Mailing address

71 Cutt Off Way
Richmond Hill, GA 31324-4126
Phone (229) 292-8091

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
PCET004185GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Chatterbox Pediatric Therapy Speech-Language Pathologist CurrentSince Mar 20, 2025 Accepting new patients

Locations

110 Pipemakers Cir
Ste 115
Pooler, GA 31322
Phone (912) 988-1526

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": "1741564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1366241788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 CUTT OFF WAY",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313244126",
            "telephone_number": "229-292-8091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PIPEMAKERS CIR STE 115",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224168",
            "telephone_number": "912-988-1526",
            "fax_number": "912-988-1537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "MACKENZIE",
        "middle_name": "NELL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "PCET004185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pooler, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; 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.