Individual provider Active NPI

Victoria Suzanne Bruce, OTRL

  • Contractor
  • Duluth, GA
National Provider Identifier
1700958303
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
OT004367 Issued in GA
Practice address
3483 Satellite Blvd
Suite 304
Duluth, GA 30096-8692
Phone
(770) 418-1778
NPI assigned
Nov 15, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X OT004367 GA Primary

Addresses

Primary practice location

3483 Satellite Blvd
Suite 304
Duluth, GA 30096-8692

Mailing address

2104 Winsburg Dr NW
Kennesaw, GA 30144-5227
Phone (770) 418-1778

Other names 1

  • Ms. Victoria Suzanne Powell Former name

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

State licenses

LicenseStateTypeSpecialty
OT004367GAMDContractor

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Atlanta Speech & Language Clinics, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700958303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 WINSBURG DR NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301445227",
            "telephone_number": "770-418-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3483 SATELLITE BLVD",
            "address_2": "SUITE 304",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300968692",
            "telephone_number": "770-418-1778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCE",
        "first_name": "VICTORIA",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "GA",
            "license": "OT004367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "POWELL",
            "middle_name": "SUZANNE",
            "prefix": "MS.",
            "credential": "OTRL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.