Carmen Melton Douglas, MED

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP005253 Issued in GA

Practice address

10354 Shepperton Court
Jonesboro, GA 30238

Phone

(404) 317-4140

Fax

(770) 603-9072

NPI assigned

Feb 12, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

Practice roles

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

• Communication Consultants

  • Speech-Language Pathologist
  • Jonesboro, GA
  • NPI 1285912345
  NPD (past) Authorized official

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

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312675200000",
    "number": "1649419821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 HIGHWAY 85 N",
            "address_2": "# 310-172",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147738",
            "telephone_number": "404-317-4140",
            "fax_number": "770-603-9072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10354 SHEPPERTON COURT",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "30238",
            "telephone_number": "404-317-4140",
            "fax_number": "770-603-9072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "CARMEN",
        "middle_name": "MELTON",
        "name_prefix": "Ms.",
        "credential": "MED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-12",
        "last_updated": "2011-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP005253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000946558D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katrina Marie Dodson
• Michael F Doherty, MD
• Ashland Doomes, DMD
• Kianna Dorsey
• Kimberlyn Doss, ANP-C
• Dove Health Care Services
• Ebony Monique Dowdy, MHS
• Benjamin Downs III, LCSW
• Jennifer Doyal, MSN, RN, FNP-BC
• Dr. Robert W. McCullough

• Speech-Language Pathologist in Jonesboro, GA
• Providers in Jonesboro, 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 Aug 7, 2011; 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.