Rhonda Lane Gray Therapy Services,Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

SLP004870 Issued in GA

Legal business name

RHONDA LANE GRAY THERAPY SERVICES,INC.

Practice address

601 N Belair SQ
#19
Evans, GA 30809-4321

Phone

(706) 833-7376

NPI assigned

Apr 30, 2015

Organization subpart

No

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

Authorized official

Name

Rhonda Lane Gray, M.A.C.C.C. S.L.P.

Title

Speech-Language Pathologist

Phone

(706) 833-7376

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430352000000",
    "number": "1366829137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1036 BARRETT DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094029",
            "telephone_number": "706-833-7376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N BELAIR SQ",
            "address_2": "#19",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094321",
            "telephone_number": "706-833-7376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RHONDA LANE GRAY THERAPY SERVICES,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-30",
        "last_updated": "2015-04-30",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_middle_name": "LANE",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "706-833-7376",
        "authorized_official_credential": "M.A.C.C.C. S.L.P."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "SLP004870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11885042",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000897993",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01900609",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Felicia Evette Rhodes, DIRECTOR
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• Erin Michelle Richardson, LPC

• Clinic/Center in Evans, GA
• Providers in Evans, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; 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.