Sydney Virginia Ponce de Leon

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP011023 Issued in GA

Practice address

495 Winn Way Ste 210
Decatur, GA 30030-1710

Phone

(770) 209-9826

NPI assigned

Jun 14, 2019

Last updated

Dec 14, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Baby Bites and Beyond, LLC

  • Speech-Language Pathologist
  • Brookhaven, GA
  • NPI 1649147984
  NPD Authorized official

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

{
    "created_epoch": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1750941555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 WINN WAY STE 210",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301710",
            "telephone_number": "770-209-9826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 WINN WAY STE 210",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301710",
            "telephone_number": "770-209-9826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONCE DE LEON",
        "first_name": "SYDNEY",
        "middle_name": "VIRGINIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-14",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "PCET002877",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP011023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@pediaspeech.com",
            "affiliation": "N",
            "address_1": "495 Winn Way Ste 210",
            "city": "Decatur",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300301710",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@pediaspeech.com",
            "affiliation": "N",
            "address_1": "495 Winn Way Ste 210",
            "city": "Decatur",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300301710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrea Florence Pollock, M.S. CCC-SLP
• Mark T Pollock, M.D.
• Rebecca Pollock, LPC
• Mildred Polnitz-Baker, RN
• Jessica Pompilus, MED
• Ponce Preventive Care LLC
• Sanjay B Ponkshe, M.D.
• Lewis Ponzo
• Alexandra Pope, SLP
• Avery Claire Pope

• Speech-Language Pathologist in Decatur, GA
• Providers in Decatur, 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 Dec 14, 2022; 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.