Peachtree City Speech and Language

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP003905 Issued in GA

Legal business name

PEACHTREE CITY SPEECH AND LANGUAGE

Practice address

277 Highway 74 N
Suite 203
Peachtree City, GA 30269-1569

Phone

(770) 363-1929

Fax

(678) 364-0858

NPI assigned

Aug 10, 2009

Organization subpart

No

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

Authorized official

Name

Jan D Williams, M.ED.-CCC/SLP

Title

Speech-Language Pathologist/Owner

Phone

77036319299

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249862400000",
    "number": "1770715724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 HIGHWAY 74 N",
            "address_2": "SUITE 203",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691569",
            "telephone_number": "770-363-1929",
            "fax_number": "678-364-0858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 HIGHWAY 74 N",
            "address_2": "SUITE 203",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691569",
            "telephone_number": "770-363-1929",
            "fax_number": "678-364-0858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE CITY SPEECH AND LANGUAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-10",
        "last_updated": "2009-08-10",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST/OWNER",
        "authorized_official_telephone_number": "77036319299",
        "authorized_official_credential": "M.ED.-CCC/SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP003905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891207907A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Peachtree City, GA
• Providers in Peachtree City, 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 Aug 10, 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.