Individual provider Active NPI

Mary Ann Mokhemar, SLP

  • Speech-Language Pathologist
  • Atlanta, GA
National Provider Identifier
1750514402
Registry record updated Aug 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP000846 Issued in GA
Practice address
1200 Lake Hearn Dr NE
Suite 250
Atlanta, GA 30319-1415
Phone
(404) 943-1070
Fax
(404) 943-0890
NPI assigned
Aug 28, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 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 SLP000846 GA Primary

Addresses

Primary practice location

1200 Lake Hearn Dr NE
Suite 250
Atlanta, GA 30319-1415

Mailing address

540 Crossbridge Aly
Johns Creek, GA 30022-7535
Phone (678) 691-5586

Other identifiers 1

IdentifierTypeStateIssuer
049102267OtherGADRIVER LICENSE

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
SLP000846GAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1251417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251417600000",
    "number": "1750514402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 CROSSBRIDGE ALY",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300227535",
            "telephone_number": "678-691-5586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 LAKE HEARN DR NE",
            "address_2": "SUITE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303191415",
            "telephone_number": "404-943-1070",
            "fax_number": "404-943-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOKHEMAR",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-28",
        "last_updated": "2009-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP000846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "049102267",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.