Active NPI
Coastal Speech & Swallowing Disorders Center, LLC
- Speech-Language Pathologist
- Statesboro, GA
National Provider Identifier
1679730386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP006272
- Legal business name
- COASTAL SPEECH & SWALLOWING DISORDERS CENTER, LLC
- Practice address
- 109 S Zetterower Ave
Statesboro, GA 30458-4898 - Phone
- (912) 489-1258
- Fax
- (912) 764-7006
- NPI assigned
- May 20, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Katherine Danilowicz, SLP
- Title
- Owner
- Phone
- (912) 489-1258
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP006272 | GA | Primary |
Addresses
Primary practice location
109 S Zetterower Ave
Statesboro, GA 30458-4898
Mailing address
PO Box 1605
Statesboro, GA 30459-1605
Phone (912) 489-1258
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211241600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1211241600000",
"number": "1679730386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1605",
"city": "STATESBORO",
"state": "GA",
"postal_code": "304591605",
"telephone_number": "912-489-1258",
"fax_number": "912-232-9700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 S ZETTEROWER AVE",
"city": "STATESBORO",
"state": "GA",
"postal_code": "304584898",
"telephone_number": "912-489-1258",
"fax_number": "912-764-7006"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COASTAL SPEECH & SWALLOWING DISORDERS CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-05-20",
"last_updated": "2008-05-20",
"status": "A",
"authorized_official_last_name": "DANILOWICZ",
"authorized_official_first_name": "KATHERINE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "912-489-1258",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "SLP"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "SLP006272",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Statesboro, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.