Organization Active NPI

Supreme Speech Therapy Services

  • Speech-Language Pathologist
  • Gainesville, GA
National Provider Identifier
1558258608
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
SUPREME SPEECH THERAPY SERVICES
Practice address
5379 Ponderosa Farm Rd
Gainesville, GA 30507-8761
Phone
(678) 736-1490
NPI assigned
Jun 20, 2025
Last updated
Jun 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Authorized official

Name
Nadia Millsap, CCC-SLPNPI 1699242719
Title
Owner
Phone
(678) 736-1490

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

5379 Ponderosa Farm Rd
Gainesville, GA 30507-8761

Mailing address

5379 Ponderosa Farm Rd
Gainesville, GA 30507-8761
Phone (678) 736-1490

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1750377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750377600000",
    "number": "1558258608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5379 PONDEROSA FARM RD",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305078761",
            "telephone_number": "678-736-1490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5379 PONDEROSA FARM RD",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305078761",
            "telephone_number": "678-736-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME SPEECH THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-20",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A",
        "authorized_official_last_name": "MILLSAP",
        "authorized_official_first_name": "NADIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-736-1490",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; 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.