Individual provider Active NPI

Emma Kerr Decarlo, SLP

  • Speech-Language Pathologist
  • Columbus, GA
National Provider Identifier
1467190850
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
PCET003541 Issued in GA
Practice address
2424 Double Churches Rd
Columbus, GA 31909-2741
Phone
(706) 324-6112
Fax
(706) 596-8259
NPI assigned
May 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2022

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 PCET003541 GA Primary

Addresses

Primary practice location

2424 Double Churches Rd
Columbus, GA 31909-2741

Mailing address

2424 Double Churches Rd
Columbus, GA 31909-2741
Phone (706) 324-6112

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220602000245 GA Practitioner - Qualified Speech Language Pathologist 1355729476 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PCET003541GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Speech & Hearing Center Speech-Language Pathologist CurrentSince Jun 1, 2022 Accepting new patients

Locations

2424 Double Churches Rd
Columbus, GA 31909
Phone (706) 324-6112

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": "1653436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1467190850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 DOUBLE CHURCHES RD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319092741",
            "telephone_number": "706-324-6112",
            "fax_number": "706-596-8259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 DOUBLE CHURCHES RD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319092741",
            "telephone_number": "706-324-6112",
            "fax_number": "706-596-8259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECARLO",
        "first_name": "EMMA",
        "middle_name": "KERR",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-25",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "PCET003541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; 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.