Individual provider Active NPI

Ashley Carlton Burdette

  • Speech-Language Pathologist
  • Decatur, GA
National Provider Identifier
1376072090
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP009666 Issued in GA
Practice address
2385 Lawrenceville Hwy Ste B
Decatur, GA 30033-3168
Phone
(404) 289-4270
NPI assigned
Jun 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 SLP009666 GA Primary

Addresses

Primary practice location

2385 Lawrenceville Hwy Ste B
Decatur, GA 30033-3168

Mailing address

810 Beaverdam Farm Rd
Canon, GA 30520-3915
Phone (706) 498-7993

Other practice location 1

3044 Due West Rd
Dallas, GA 30157-2125
Phone (770) 443-9672

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
SLP009666GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dream Catcher Pediatric Therapy Services, Inc. Speech-Language Pathologist Past Accepting new patients
Village Pathways Comprehensive Therapy, LLC Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1376072090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 BEAVERDAM FARM RD",
            "city": "CANON",
            "state": "GA",
            "postal_code": "305203915",
            "telephone_number": "706-498-7993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2385 LAWRENCEVILLE HWY STE B",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333168",
            "telephone_number": "404-289-4270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3044 Due West Rd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "GA",
            "postal_code": "301572125",
            "country_code": "US",
            "telephone_number": "770-443-9672",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURDETTE",
        "first_name": "ASHLEY",
        "middle_name": "CARLTON",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP009666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.