Gwen Sparkman, M.ED. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP007736 Issued in GA

Practice address

185 Nicholson Farm Rd
Blairsville, GA 30512-2814

Phone

(706) 897-5489

NPI assigned

Feb 10, 2014

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)

Enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1391990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1609290709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 NICHOLSON FARM RD",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305122814",
            "telephone_number": "706-897-5489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 NICHOLSON FARM RD",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305122814",
            "telephone_number": "706-897-5489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARKMAN",
        "first_name": "GWEN",
        "credential": "M.ED. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-10",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "14127",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP007736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Danielle Snider, FNP
• Southeast Eye Group LLC
• Southland Medical Group, LLC
• Southland Union Emergency Medical Services, LLC
• Kimberly Albury Spade, M.ED., CCC-SLP
• Debra D Spaulding
• Lewis Anthony Stanley, CRNA
• Cindy Buckner Starke, MD
• Howard Thomas Starrett Jr.
• Staton Family Dentistry

• Speech-Language Pathologist in Blairsville, GA
• Providers in Blairsville, 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 May 12, 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.