Organization Active NPI

Coastal Speech & Swallowing Disorders Center, LLC

  • Speech-Language Pathologist
  • Statesboro, GA
National Provider Identifier
1679730386
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP006272 Issued in GA
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

Updated by the provider on May 20, 2008

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)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

NPI 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.

Verify at the official NPI Registry.