Shannon Lamar, CCC-SLP – Speech-Language Pathologist

Key facts

NPI: 1699347260
Entity type: Individual (NPI type 1)
Primary specialty: Speech-Language Pathologist 235Z00000X
License: SLP011636 (GA)
Practice address: 1777 Northeast Expy NE Ste 120
Brookhaven, GA 30329-2475
Phone: (404) 228-8558
NPI assigned: Jul 13, 2021
Sex: Female
Sole proprietor: Yes

Organizations & group practices 2

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.

Buckhead Speech Specialists, Inc. Speech-Language Pathologist · Atlanta, GA · NPI 1477081487

NPD (past) SPEECH-LANGUAGE PATHOLOGIST
Propel Pediatric Therapy, Inc. Speech-Language Pathologist · Brookhaven, GA · NPI 1508557802

NPD (past) SPEECH-LANGUAGE PATHOLOGIST

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
SLP011636	GA	MD	Speech-Language Pathologist

Practice roles

Organization	Specialty	Status	New patients
Buckhead Speech Specialists, Inc.	Speech-Language Pathologist	Past since Jul 1, 2021	Accepting new patients
Propel Pediatric Therapy, Inc.	Speech-Language Pathologist	Past since May 1, 2023	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Speech-Language Pathologist	235Z00000X
Speech-Language Pathologist	235Z00000X	SLP011636	GA	Yes

Addresses

Primary practice location

1777 Northeast Expy NE Ste 120
Brookhaven, GA 30329-2475

Mailing address

1731 Briarvista Way NE
Atlanta, GA 30329-3640
Phone (478) 731-6825

Other practice location 1

300 W Wieuca Rd NE Ste 200
Atlanta, GA 30342-3352
Phone (404) 808-5427

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 30, 2023.

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1699347260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1731 BRIARVISTA WAY NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303293640",
            "telephone_number": "478-731-6825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 NORTHEAST EXPY NE STE 120",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303292475",
            "telephone_number": "404-228-8558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 W Wieuca Rd NE Ste 200",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303423352",
            "country_code": "US",
            "telephone_number": "404-808-5427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAMAR",
        "first_name": "SHANNON",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-13",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP011636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, GA

All providers in Brookhaven, GA · Speech-Language Pathologist in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.