Individual provider Active NPI

Krista Belville Jones, MS, CCC-SLP

  • Speech-Language Pathologist
  • Duluth, GA
National Provider Identifier
1629561782
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
012285 Issued in GA
Practice address
4855 River Green Pkwy Ste 610
Duluth, GA 30096-8337
Phone
(470) 499-1116
Fax
(866) 321-1385
NPI assigned
Jun 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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 28462 CA
Speech-Language Pathologist 235Z00000X 012285 GA Primary

Addresses

Primary practice location

4855 River Green Pkwy Ste 610
Duluth, GA 30096-8337

Mailing address

5805 State Bridge Rd # G-328
Johns Creek, GA 30097-8220
Phone (951) 216-0090

Other names 1

  • Krista Belville Williams Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230106001088 GA Practitioner - Qualified Speech Language Pathologist 4587997291

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
012285GAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1629561782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5805 STATE BRIDGE RD # G-328",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300978220",
            "telephone_number": "951-216-0090",
            "fax_number": "470-499-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 RIVER GREEN PKWY STE 610",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300968337",
            "telephone_number": "470-499-1116",
            "fax_number": "866-321-1385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "KRISTA",
        "middle_name": "BELVILLE",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-12",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "28462",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "012285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTA",
            "last_name": "WILLIAMS",
            "middle_name": "BELVILLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.