Active NPI
Kaitlyn Mendenhall Berry, SLP
- Speech-Language Pathologist
- Decatur, GA
National Provider Identifier
1649708777
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- PCET002431
- Practice address
- 1583 Riderwood CT
Decatur, GA 30033-1505 - Phone
- (678) 429-3790
- NPI assigned
- Jun 2, 2017
- Sex
- Female
- Sole proprietor
- No
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 | PCET002431 | GA | Primary |
Addresses
Primary practice location
1583 Riderwood CT
Decatur, GA 30033-1505
Mailing address
102 Pierrepont Isle
Duluth, GA 30097-5908
Phone (678) 381-7587
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PCET002431 | GA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rand Speech Pathology LLC | Speech-Language Pathologist | Past | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496361600000",
"number": "1649708777",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 PIERREPONT ISLE",
"city": "DULUTH",
"state": "GA",
"postal_code": "300975908",
"telephone_number": "678-381-7587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1583 RIDERWOOD CT",
"city": "DECATUR",
"state": "GA",
"postal_code": "300331505",
"telephone_number": "678-429-3790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERRY",
"first_name": "KAITLYN",
"middle_name": "MENDENHALL",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-02",
"last_updated": "2017-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "PCET002431",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.