Bertha Williams, PT

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP009530 Issued in GA

Practice address

3186 Ashton Old Rd
Douglasville, GA 30135-8195

Phone

(770) 329-0963

NPI assigned

Apr 17, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Atlanta Pediatric Therapy, Inc.

  • Early Intervention Provider Agency
  • Chamblee, GA
  • NPI 1578622593
  NPD (past)

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492387200000",
    "number": "1538693403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 LAKE PARK DR SE STE 102",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300807639",
            "telephone_number": "770-329-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3186 ASHTON OLD RD",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301358195",
            "telephone_number": "770-329-0963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BERTHA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-17",
        "last_updated": "2017-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP009530",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Michelle Wilkes
• Janine Celia Willey, L.M.T., C.N.M.T
• William W. Tung MD P.C.
• Williams Pharmacy
• Antonio Alexander Williams, M.D.
• Dianna Williams, LPN
• Felicia M Williams, LPC
• Jacques R. Williams, DDS
• Jaden Williams
• Jasmine Williams

• Speech-Language Pathologist in Douglasville, GA
• Providers in Douglasville, 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 Apr 17, 2017; 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.