NPIMap

Organization Active NPI

Fairburn Speech & Swallow, LLC

  • Speech-Language Pathologist
  • Fairburn, GA
National Provider Identifier
1699018853
Registry record updated Apr 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP007350 Issued in GA
Legal business name
FAIRBURN SPEECH & SWALLOW, LLC
Practice address
7863 Heathmore Dr
Fairburn, GA 30213-7418
Phone
(770) 774-2223
Fax
(770) 774-2223
NPI assigned
Apr 5, 2013
Last updated
Apr 5, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2013

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

Authorized official

Name
Ms. Ashanti Taruvinga, M.ED. CCC-SLPNPI 1407125693
Title
Part Owner/ Service Provider
Phone
(770) 774-2223

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X SLP007350 GA Primary

Addresses

Primary practice location

7863 Heathmore Dr
Fairburn, GA 30213-7418

Mailing address

7863 Heathmore Dr
Fairburn, GA 30213-7418
Phone (770) 774-2223

Other identifiers 1

IdentifierTypeStateIssuer
003125147AMedicaidGA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1365120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365120000000",
    "number": "1699018853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7863 HEATHMORE DR",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302137418",
            "telephone_number": "770-774-2223",
            "fax_number": "770-774-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7863 HEATHMORE DR",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302137418",
            "telephone_number": "770-774-2223",
            "fax_number": "770-774-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRBURN SPEECH & SWALLOW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-05",
        "last_updated": "2013-04-05",
        "status": "A",
        "authorized_official_last_name": "TARUVINGA",
        "authorized_official_first_name": "ASHANTI",
        "authorized_official_title_or_position": "PART OWNER/ SERVICE PROVIDER",
        "authorized_official_telephone_number": "770-774-2223",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.ED. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP007350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003125147A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairburn, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2013; 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.