Active NPI
Amber Baldwin
- Speech-Language Pathologist
- Lawrenceville, GA
National Provider Identifier
1639880982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- PCET003740
- Practice address
- 1130 Hurricane Shoals Rd NE
Lawrenceville, GA 30043-4851 - Phone
- (470) 323-6711
- NPI assigned
- Dec 7, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | PCET003740 | GA | Primary |
Addresses
Primary practice location
1130 Hurricane Shoals Rd NE
Lawrenceville, GA 30043-4851
Mailing address
215 Autumn Village CT
Duluth, GA 30096-7580
Phone (334) 455-9276
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250131001051 | GA | Practitioner - Qualified Speech Language Pathologist | 6608305990 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PCET003740 | GA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670371200000",
"number": "1639880982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 AUTUMN VILLAGE CT",
"city": "DULUTH",
"state": "GA",
"postal_code": "300967580",
"telephone_number": "334-455-9276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 HURRICANE SHOALS RD NE",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300434851",
"telephone_number": "470-323-6711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALDWIN",
"first_name": "AMBER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-12-07",
"last_updated": "2022-12-07",
"certification_date": "2022-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "PCET003740",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.