NPIMap

Organization Active NPI

Board of Regents of the University System of Georgia

Doing business as The University of Georgia Speech and Hearing Clinic

  • Audiologist
  • Athens, GA
National Provider Identifier
1376640557
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Legal business name
BOARD OF REGENTS OF THE UNIVERSITY SYSTEM OF GEORGIA
Doing business as
The University of Georgia Speech and Hearing Clinic
UGA Speech and Hearing Clinic
Practice address
110 Carlton St. 593 Aderhold Hall
Athens, GA 30602-5004
Phone
(706) 542-4598
Fax
(706) 542-4574
NPI assigned
Sep 20, 2006
Last updated
May 24, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Authorized official

Name
Terry J RaganNPI 1245396043
Title
Clinic Director
Phone
(919) 937-4222

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X NU Primary
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

110 Carlton St. 593 Aderhold Hall
Athens, GA 30602-5004

Mailing address

110 Carlton St
Athens, GA 30602-5004
Phone (706) 542-4598

Other identifiers 1

IdentifierTypeStateIssuer
000395403AMedicaidGA

Other names 2

  • The University of Georgia Speech and Hearing Clinic Doing business as
  • UGA Speech and Hearing Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040602001084 GA Part B Supplier - Clinic/Group Practice 8729060967 Receives reassigned benefits from 21 practitioners
4 other NPIs on this enrollment
Practice locations: Athens, GA

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

110 Carlton St
#593
Athens, GA 30602
Phone (706) 424-6844

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1376640557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 CARLTON ST",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306025004",
            "telephone_number": "706-542-4598",
            "fax_number": "706-542-4574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CARLTON ST. 593 ADERHOLD HALL",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306025004",
            "telephone_number": "706-542-4598",
            "fax_number": "706-542-4574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOARD OF REGENTS OF THE UNIVERSITY SYSTEM OF GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "RAGAN",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "919-937-4222"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000395403A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The University of Georgia Speech and Hearing Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UGA Speech and Hearing Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.