Primary Pathways, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP005791 Issued in GA

Legal business name

PRIMARY PATHWAYS, LLC

Practice address

2385 Lawrenceville Hwy Ste B-2
Decatur, GA 30033-3168

Phone

(770) 500-5508

Fax

(404) 597-4050

NPI assigned

Mar 28, 2014

Organization subpart

No

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

Authorized official

Name

Jacqueline Denise Murry, PHD, CCC-SLPNPI 1225189574

Title

Owner/President

Phone

(770) 500-5508

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Primary Pathways Speech & Language Services, LLC Other name

Electronic endpoints 1

Tax ID family

Primary Pathways LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Primary Pathways, LLC

  • Speech-Language Pathologist
  • Smyrna, GA
  • NPI 1649536640
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacqueline Denise Murry, PH.D

  • Speech-Language Pathologist
  • Decatur, GA
  • NPI 1225189574
  NPD Authorized official

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

{
    "created_epoch": "1395964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592438400000",
    "number": "1528485455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2385 LAWRENCEVILLE HWY STE B-2",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333168",
            "telephone_number": "770-500-5508",
            "fax_number": "404-597-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2385 LAWRENCEVILLE HWY STE B-2",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333168",
            "telephone_number": "770-500-5508",
            "fax_number": "404-597-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY PATHWAYS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-28",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A",
        "authorized_official_last_name": "MURRY",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "770-500-5508",
        "authorized_official_credential": "PHD, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP005791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "674689092D",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Decatur",
            "affiliation": "N",
            "address_1": "2385 Lawrenceville Hwy Ste B-2",
            "city": "Decatur",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300333168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Primary Pathways Speech & Language Services, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Speech-Language Pathologist in Decatur, GA
• Providers in Decatur, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.