Active NPI
Katharine Gridley
- Speech-Language Pathologist
- Fayetteville, GA
National Provider Identifier
1497787311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 001692
- Practice address
- 500 W Lanier Ave
Suite 702
Fayetteville, GA 30214-7636 - Phone
- (770) 719-0375
- Fax
- (678) 817-0330
- NPI assigned
- Jul 7, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 001692 | GA | Primary |
Addresses
Primary practice location
500 W Lanier Ave
Suite 702
Fayetteville, GA 30214-7636
Mailing address
500 W Lanier Ave
Suite 702
Fayetteville, GA 30214-7636
Phone (770) 719-0375
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
| License | State | Type | Specialty |
|---|---|---|---|
| 001692 | GA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497787311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 W LANIER AVE",
"address_2": "SUITE 702",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302147636",
"telephone_number": "770-719-0375",
"fax_number": "678-817-0330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 W LANIER AVE",
"address_2": "SUITE 702",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302147636",
"telephone_number": "770-719-0375",
"fax_number": "678-817-0330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIDLEY",
"first_name": "KATHARINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "001692",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.