Active NPI
Marlene Prejean
- Speech-Language Pathologist
- Decatur, GA
National Provider Identifier
1730233396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP003766
- Practice address
- 4535 Flat Shoals Pkwy
Suite 301
Decatur, GA 30034-5039 - Phone
- (404) 245-6457
- NPI assigned
- Jan 22, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP003766 | GA | Primary |
Addresses
Primary practice location
4535 Flat Shoals Pkwy
Suite 301
Decatur, GA 30034-5039
Mailing address
4535 Flat Shoals Pkwy
Suite 301
Decatur, GA 30034-5039
Phone (404) 245-6457
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000813535F | Medicaid | GA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| SLP003766 | GA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357776000000",
"number": "1730233396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4535 FLAT SHOALS PKWY",
"address_2": "SUITE 301",
"city": "DECATUR",
"state": "GA",
"postal_code": "300345039",
"telephone_number": "404-245-6457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4535 FLAT SHOALS PKWY",
"address_2": "SUITE 301",
"city": "DECATUR",
"state": "GA",
"postal_code": "300345039",
"telephone_number": "404-245-6457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PREJEAN",
"first_name": "MARLENE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2013-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "SLP003766",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000813535F",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.