Individual provider Active NPI

Keion Kerr

  • Speech-Language Pathologist
  • Conyers, GA
National Provider Identifier
1588023709
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP009143 Issued in GA
Practice address
402 Derbyshire CT SE
Conyers, GA 30094-4261
Phone
(678) 993-9577
NPI assigned
Feb 16, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP009143 GA Primary

Addresses

Primary practice location

402 Derbyshire CT SE
Conyers, GA 30094-4261

Mailing address

402 Derbyshire CT SE
Conyers, GA 30094-4261
Phone (678) 993-9577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SLP009143GAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1588023709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 DERBYSHIRE CT SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300944261",
            "telephone_number": "678-993-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 DERBYSHIRE CT SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300944261",
            "telephone_number": "678-993-9577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERR",
        "first_name": "KEION",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-16",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP009143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; 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.