Carnell Durrel Roberts Jr.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

PCET001966 Issued in GA

Practice address

6135 Roosevelt Hwy
Warm Springs, GA 31830-2757

Phone

(706) 655-5432

NPI assigned

Sep 20, 2013

Last updated

Sep 20, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379635200000",
    "number": "1730515875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 572",
            "city": "WARM SPRINGS",
            "state": "GA",
            "postal_code": "318300572",
            "telephone_number": "706-741-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6135 ROOSEVELT HWY",
            "city": "WARM SPRINGS",
            "state": "GA",
            "postal_code": "318302757",
            "telephone_number": "706-655-5432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "CARNELL",
        "middle_name": "DURREL",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-20",
        "last_updated": "2013-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "PCET001966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Denise Perryman, RN-BSN CRRN
• Michelle Razon Raguindin, PHARMD
• Emily Nicole Reffitt, PT, DPT
• Kelly J Rice, OTRL
• Rhett Anthony Roberson, DPT
• Roosevelt Warm Springs Rehabilitation & Specialty Hospitals (Roosevelt Warm Springs Hospitalist)
• S&D Personal Care Services
• Shadow Horse Counseling, LLC
• Ashley Smith, FNP-C
• Kathryn Ann Smith, PT

• Speech-Language Pathologist in Warm Springs, GA
• Providers in Warm Springs, 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 Sep 20, 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.

Verify at the official NPI Registry.