Individual provider Active NPI

Tequesta Venia Diggs

  • Speech-Language Pathologist
  • Thomasville, GA
National Provider Identifier
1720315724
Registry record updated Nov 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
PCET001493 Issued in GA
Practice address
7544 Metcalf Rd
Thomasville, GA 31792-8638
Phone
(229) 236-1013
Fax
(229) 226-6353
NPI assigned
Nov 11, 2009
Last updated
Nov 11, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2009

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 PCET001493 GA Primary

Addresses

Primary practice location

7544 Metcalf Rd
Thomasville, GA 31792-8638

Mailing address

713 Varnedoe St
Thomasville, GA 31792-7245
Phone (229) 236-1013

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
PCET001493GAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1257897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257897600000",
    "number": "1720315724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 VARNEDOE ST",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317927245",
            "telephone_number": "229-236-1013",
            "fax_number": "229-226-6353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7544 METCALF RD",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317928638",
            "telephone_number": "229-236-1013",
            "fax_number": "229-226-6353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIGGS",
        "first_name": "TEQUESTA",
        "middle_name": "VENIA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-11",
        "last_updated": "2009-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "PCET001493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2009; 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.