Individual provider Active NPI

Ashley Valderrama, MS, CCC-SLP

  • Speech-Language Pathologist
  • Jasper, GA
National Provider Identifier
1386420107
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP012689 Issued in GA
Practice address
1266 Highway 515 S
Jasper, GA 30143-4872
Phone
(706) 692-9016
Fax
(706) 253-0177
NPI assigned
Sep 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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 SLP012689 GA Primary

Addresses

Primary practice location

1266 Highway 515 S
Jasper, GA 30143-4872

Mailing address

1266 Highway 515 S
Jasper, GA 30143-4872
Phone (706) 692-9016

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SLP012689GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Building Bridges Therapy Inc Speech-Language Pathologist PastSince Sep 1, 2023 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": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1386420107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1266 HIGHWAY 515 S",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301434872",
            "telephone_number": "706-692-9016",
            "fax_number": "706-253-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1266 HIGHWAY 515 S",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301434872",
            "telephone_number": "706-692-9016",
            "fax_number": "706-253-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDERRAMA",
        "first_name": "ASHLEY",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP012689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.