Individual provider Active NPI

Patricia Gauthier, MA CCC-SLP

  • Speech-Language Pathologist
  • Suwanee, GA
National Provider Identifier
1619585395
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
008009 Issued in GA
Practice address
2517 Collins Port CV
Suwanee, GA 30024-2787
Phone
(614) 753-5588
NPI assigned
Jul 17, 2020
Last updated
Aug 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 10605 OH
Speech-Language Pathologist 235Z00000X 008009 GA Primary

Addresses

Primary practice location

2517 Collins Port CV
Suwanee, GA 30024-2787

Mailing address

2517 Collins Port CV
Suwanee, GA 30024-2787
Phone (614) 753-5588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200908003098 GA Practitioner - Qualified Speech Language Pathologist 7911325964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2517 Collins Port CV
Suwanee, GA 30024-2787
Phone (614) 753-5588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
008009GAMDSpeech-Language Pathologist
10605OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascend Speech and Swallowing LLC Speech-Language Pathologist CurrentSince Jul 28, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1594944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1619585395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2517 COLLINS PORT CV",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242787",
            "telephone_number": "614-753-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2517 COLLINS PORT CV",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242787",
            "telephone_number": "614-753-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUTHIER",
        "first_name": "PATRICIA",
        "name_prefix": "Mrs.",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-17",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "10605",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "008009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.