Elizabeth Peavy, M.ED.CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP008920 Issued in GA

Practice address

536 Grand Slam Dr
Evans, GA 30809-8044

Phone

(706) 854-8434

Fax

(706) 854-8435

NPI assigned

Aug 13, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Therapy Trails of Evans

  • Multi-Specialty Clinic/Center
  • Evans, GA
  • NPI 1124677919

  Speech-Language Pathologist

  NPD Authorized official
• Therapy Trails, LLC

  • Speech-Language Pathologist
  • Grovetown, GA
  • NPI 1760993497
  NPD Authorized official

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

{
    "created_epoch": "1407888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435536000000",
    "number": "1376942508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 GRAND SLAM DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308098044",
            "telephone_number": "706-854-8434",
            "fax_number": "706-854-8435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 GRAND SLAM DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308098044",
            "telephone_number": "706-854-8434",
            "fax_number": "706-854-8435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEAVY",
        "first_name": "ELIZABETH",
        "credential": "M.ED.CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-13",
        "last_updated": "2015-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP008920",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "PCET002045",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aubrie Michelle Patrick, NP-C
• Pdaa 2 Evans LLC
• Peace and Comfort Home Health Care LLC
• Lamar B Peacock, MD
• Jason Leonard Pearce, LCSW
• Jennifer R. Pedersen, DO
• Pediatric Partners of Augusta, LLC
• Dawn Marie Warren Peel, LPC
• Dorthe Rauholt Peloquin, M.D.
• Carla M Pennington, M.ED. CCC-SLP

• Speech-Language Pathologist in Evans, GA
• Providers in Evans, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.