Krystal S. Gambrell, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP007461 Issued in GA

Practice address

4075 Demooney Rd
College Park, GA 30349-1312

Phone

(404) 520-0087

Fax

(833) 569-5677

NPI assigned

Nov 19, 2010

Last updated

Dec 21, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Krystal Klear Speech Services

  • Speech-Language Pathologist
  • College Park, GA
  • NPI 1477199073
  Authorized official Same address or phone

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

{
    "created_epoch": "1290124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1629370853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 N HIGHLAND AVE NE",
            "address_2": "SUITE 275",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303064530",
            "telephone_number": "404-575-4000",
            "fax_number": "404-575-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4075 DEMOONEY RD",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303491312",
            "telephone_number": "404-520-0087",
            "fax_number": "833-569-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBRELL",
        "first_name": "KRYSTAL",
        "middle_name": "S.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-19",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP007461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edmond Michael Franklin, DDS
• Aisha Frazier
• Fidelia Choose Frempong, RBT
• Fruit of My Womb Inc
• Fulton County Board of Health (College Park Regional Health Center)
• Sharon Ann Ganaway, CERTIFIED NURSE/TECH
• Georgia Clinics LLC
• Kylie Gerks, MS, MFT
• Leandre Daniel Gervais, DDS
• Tara Ann Gill, M.S.

• Speech-Language Pathologist in College Park, GA
• Providers in College Park, 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 Dec 21, 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.