Individual provider Active NPI

Nicole Dionne Mays, MA, CCC-SLP

  • Speech-Language Pathologist
  • Leesburg, GA
National Provider Identifier
1720133556
Registry record updated Sep 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP006010 Issued in GA
Practice address
100 Paula CT
Leesburg, GA 31763-6213
Phone
(229) 449-0142
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2012

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 SLP006010 GA Primary

Addresses

Primary practice location

100 Paula CT
Leesburg, GA 31763-6213

Mailing address

PO Box 1371
Leesburg, GA 31763-1371
Phone (229) 449-0142

Other identifiers 1

IdentifierTypeStateIssuer
171197100BMedicaidGA

Other names 1

  • Miss Nicole Dionne Moseley 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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SLP006010GAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347840000000",
    "number": "1720133556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1371",
            "city": "LEESBURG",
            "state": "GA",
            "postal_code": "317631371",
            "telephone_number": "229-449-0142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PAULA CT",
            "city": "LEESBURG",
            "state": "GA",
            "postal_code": "317636213",
            "telephone_number": "229-449-0142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYS",
        "first_name": "NICOLE",
        "middle_name": "DIONNE",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2012-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP006010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171197100B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "MOSELEY",
            "middle_name": "DIONNE",
            "prefix": "MISS",
            "credential": "MA, CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Leesburg, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2012; 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.