Ralph Smith Deloach III, M.ED.,CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP004677 Issued in GA

Practice address

3615 Braselton Hwy
Suite 103
Dacula, GA 30019-5906

Phone

(678) 377-9634

Fax

(678) 377-9609

NPI assigned

Nov 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586217600000",
    "number": "1730255035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3615 BRASELTON HWY",
            "address_2": "SUITE 103",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300195906",
            "telephone_number": "678-377-9634",
            "fax_number": "678-377-9609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 BRASELTON HWY",
            "address_2": "SUITE 103",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300195906",
            "telephone_number": "678-377-9634",
            "fax_number": "678-377-9609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELOACH",
        "first_name": "RALPH",
        "middle_name": "SMITH",
        "name_suffix": "III",
        "credential": "M.ED.,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP004677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10035715",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305500",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "52813029-001",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nikki Daniels
• Elizabeth Danish, PT/DPT
• Leslie Conger Davis, RD, LD, CDE
• Jean Davison, OTL
• Del Mar Healthcare LLC
• Seetal J Deluca
• Sarah Lyne Denize
• Dennison Investments
• William Dennison
• Dental Smiles of America LLC

• Speech-Language Pathologist in Dacula, GA
• Providers in Dacula, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2020; 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.