Individual provider Active NPI

Stephanie L. Sanders

  • Speech-Language Pathologist
  • Watkinsville, GA
National Provider Identifier
1376794040
Registry record updated Sep 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP 005910 Issued in GA
Practice address
2981 Hog Mountain Rd
Watkinsville, GA 30677-1819
Phone
(706) 769-0922
NPI assigned
Sep 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2008

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 SLP 005910 GA Primary

Addresses

Primary practice location

2981 Hog Mountain Rd
Watkinsville, GA 30677-1819

Mailing address

523 Providence Cir
Statham, GA 30666-2132
Phone (770) 725-6213

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
SLP 005910GAMDSpeech-Language Pathologist

Practice roles

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222732800000",
    "number": "1376794040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 PROVIDENCE CIR",
            "city": "STATHAM",
            "state": "GA",
            "postal_code": "306662132",
            "telephone_number": "770-725-6213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2981 HOG MOUNTAIN RD",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306771819",
            "telephone_number": "706-769-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "STEPHANIE",
        "middle_name": "L.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-30",
        "last_updated": "2008-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP 005910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watkinsville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; 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.