Individual provider Active NPI

Teresa Michele Bauserman, M.S.ED, CCC-SLP

  • Speech-Language Pathologist
  • Marietta, GA
National Provider Identifier
1467769448
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP10845 Issued in GA
Practice address
1230 Johnson Ferry PL Ste G10
Marietta, GA 30068-2045
Phone
(423) 741-4209
NPI assigned
Sep 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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 SLP10845 GA Primary

Addresses

Primary practice location

1230 Johnson Ferry PL Ste G10
Marietta, GA 30068-2045

Mailing address

5529 Merner LN
Virginia Beach, VA 23455-6631
Phone (423) 741-4209

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
SLP10845GAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1284163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1467769448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5529 MERNER LN",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556631",
            "telephone_number": "423-741-4209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 JOHNSON FERRY PL STE G10",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300682045",
            "telephone_number": "423-741-4209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUSERMAN",
        "first_name": "TERESA",
        "middle_name": "MICHELE",
        "name_prefix": "Mrs.",
        "credential": "M.S.ED, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-11",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP10845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.