NPIMap

Organization Active NPI

Pediaspeech Services, Inc.

  • Speech-Language Pathologist
  • Norcross, GA
National Provider Identifier
1508902446
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
PEDIASPEECH SERVICES, INC.
Practice address
6075 Atlantic Blvd
Suite G-1
Norcross, GA 30071-1349
Phone
(770) 209-9826
Fax
(770) 209-9876
NPI assigned
Jan 29, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jennifer McCullough, M.S., CCC-SLPNPI 1073683942
Title
Owner and Director
Phone
(770) 209-9826

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X NU Primary

Addresses

Primary practice location

6075 Atlantic Blvd
Suite G-1
Norcross, GA 30071-1349

Mailing address

6075 Atlantic Blvd
Suite G-1
Norcross, GA 30071-1349
Phone (770) 209-9826

National Provider Directory

National Provider Directory

Locations

6075 Atlantic Blvd
Ste G1
Norcross, GA 30071
Phone (770) 209-9826

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508902446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6075 ATLANTIC BLVD",
            "address_2": "SUITE G-1",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300711349",
            "telephone_number": "770-209-9826",
            "fax_number": "770-209-9876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6075 ATLANTIC BLVD",
            "address_2": "SUITE G-1",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300711349",
            "telephone_number": "770-209-9826",
            "fax_number": "770-209-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIASPEECH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER AND DIRECTOR",
        "authorized_official_telephone_number": "770-209-9826",
        "authorized_official_credential": "M.S., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.