NPIMap

John W. Looper Jr. Speech & Hearing Clinic

Organization Active NPI Speech-Language Pathologist · Dalton, GA

NPI 1720098536 · NPPES record last updated Jun 12, 2009

Key facts

NPI
1720098536
Entity type
Organization (NPI type 2)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
J213493 (GA)
Legal business name
JOHN W. LOOPER JR. SPEECH & HEARING CLINIC
Practice address
1011 Professional Blvd
Dalton, GA 30720-2506
Phone
(706) 226-4623
Fax
(706) 278-0580
NPI assigned
Aug 8, 2006
Organization subpart
No

Authorized official

Name
Ms. Kathie Lane Edwards, MA
Title
President/Ceo
Phone
(706) 226-4623

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

1011 Professional Blvd
Dalton, GA 30720
Phone (706) 217-6950

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist
Group: 193200000X MULTI-SPECIALTY GROUP		 231H00000X J213493 GA
Speech-Language Pathologist
Group: 193200000X MULTI-SPECIALTY GROUP		 235Z00000X J213493 GA Yes

Addresses

Primary practice location

1011 Professional Blvd
Dalton, GA 30720-2506

Mailing address

1011 Professional Blvd
Dalton, GA 30720-2506
Phone (706) 226-4623

Other identifiers

IdentifierTypeStateIssuer
000196314AMedicaidGA

Other names

  • Looper Speech & Hearing Center Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 12, 2009.

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244764800000",
    "number": "1720098536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 PROFESSIONAL BLVD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202506",
            "telephone_number": "706-226-4623",
            "fax_number": "706-278-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 PROFESSIONAL BLVD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202506",
            "telephone_number": "706-226-4623",
            "fax_number": "706-278-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN W. LOOPER JR. SPEECH & HEARING CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2009-06-12",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "KATHIE",
        "authorized_official_middle_name": "LANE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "706-226-4623",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": "GA",
            "license": "J213493",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "J213493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000196314A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Looper Speech & Hearing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dalton, GA

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

Sources for this page

Verify at the official NPI Registry.