Individual provider Active NPI

Breanna Nicole Ward

  • Speech-Language Pathologist
  • Woodstock, GA
National Provider Identifier
1497646830
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP011459 Issued in GA
Practice address
10917 Highway 92 Ste 130&140
Woodstock, GA 30188-6329
Phone
(678) 447-1617
Fax
(678) 735-7505
NPI assigned
Jul 14, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 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 SLP011459 GA Primary

Addresses

Primary practice location

10917 Highway 92 Ste 130&140
Woodstock, GA 30188-6329

Mailing address

4006 Riverchess Dr SW
Atlanta, GA 30331-6016
Phone (404) 434-4538

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
SLP011459GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bridge the Gap Therapy Speech-Language Pathologist CurrentSince Jul 22, 2025 Accepting new patients

Locations

10917 Highway 92
Ste 130140
Woodstock, GA 30188
Phone (678) 447-1617

10917 Highway 92
Ste 130
Woodstock, GA 30188
Phone (678) 447-1617

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": "1752451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1497646830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4006 RIVERCHESS DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303316016",
            "telephone_number": "404-434-4538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10917 HIGHWAY 92 STE 130&140",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301886329",
            "telephone_number": "678-447-1617",
            "fax_number": "678-735-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "BREANNA",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-14",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP011459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.