Individual provider Active NPI

Vivian W Stern, M.ED, CCC-SLP

  • Speech-Language Pathologist
  • Americus, GA
National Provider Identifier
1699831388
Registry record updated May 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP003011 Issued in GA
Practice address
2366 Lee Street Rd
Americus, GA 31709-9243
Phone
(229) 931-1274
Fax
(229) 931-1314
NPI assigned
Dec 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP003011 GA Primary

Addresses

Primary practice location

2366 Lee Street Rd
Americus, GA 31709-9243

Mailing address

2366 Lee Street Rd
Americus, GA 31709-9243
Phone (229) 931-1274

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
SLP003011GAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369699200000",
    "number": "1699831388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2366 LEE STREET RD",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317099243",
            "telephone_number": "229-931-1274",
            "fax_number": "229-931-1314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2366 LEE STREET RD",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317099243",
            "telephone_number": "229-931-1274",
            "fax_number": "229-931-1314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "VIVIAN",
        "middle_name": "W",
        "credential": "M.ED, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2013-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP003011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Americus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.