Individual provider Active NPI

Marjory Kerzner-Wilson

  • Speech-Language Pathologist
  • Savannah, GA
National Provider Identifier
1487061396
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
109758 Issued in GA
Practice address
1000 Eisenhower Dr
Savannah, GA 31406-2601
Phone
(912) 335-1650
NPI assigned
Jul 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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 109758 GA Primary

Addresses

Primary practice location

1000 Eisenhower Dr
Savannah, GA 31406-2601

Mailing address

32 S Rockwell Ave
Savannah, GA 31419-3018
Phone (912) 224-2112

Other identifiers 2

IdentifierTypeStateIssuer
109758OtherGAGEORGIA EDUCATOR CERTIFICATE
SLP009120OtherGAGA SLP LICENSE

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
109758GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southland Therapy Services, Inc 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": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1487061396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 S ROCKWELL AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314193018",
            "telephone_number": "912-224-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 EISENHOWER DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062601",
            "telephone_number": "912-335-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERZNER-WILSON",
        "first_name": "MARJORY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-14",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "109758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA EDUCATOR CERTIFICATE",
            "identifier": "109758",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA SLP LICENSE",
            "identifier": "SLP009120",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.