NPIMap

Organization Active NPI

Discover Speech LLC

  • Speech-Language Pathologist
  • Mableton, GA
National Provider Identifier
1538464797
Registry record updated Jan 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP005864 Issued in GA
Legal business name
DISCOVER SPEECH LLC
Practice address
6624 Saint Abernathy Dr SE
Mableton, GA 30126-6409
Phone
(404) 808-5770
NPI assigned
Jan 20, 2011
Last updated
Jan 20, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2011

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

Authorized official

Name
Mrs. Adina Bradshaw, MS CCC-SLP
Title
Ceo/Speech Therapist
Phone
(404) 808-5770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X SLP005864 GA Primary

Addresses

Primary practice location

6624 Saint Abernathy Dr SE
Mableton, GA 30126-6409

Mailing address

6624 Saint Abernathy Dr SE
Mableton, GA 30126-6409
Phone (404) 808-5770

Other identifiers 1

IdentifierTypeStateIssuer
398770620BMedicaidGA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1295481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295481600000",
    "number": "1538464797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6624 SAINT ABERNATHY DR SE",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301266409",
            "telephone_number": "404-808-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6624 SAINT ABERNATHY DR SE",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301266409",
            "telephone_number": "404-808-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISCOVER SPEECH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-20",
        "last_updated": "2011-01-20",
        "status": "A",
        "authorized_official_last_name": "BRADSHAW",
        "authorized_official_first_name": "ADINA",
        "authorized_official_title_or_position": "CEO/SPEECH THERAPIST",
        "authorized_official_telephone_number": "404-808-5770",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP005864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "398770620B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mableton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; 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.