Active NPI
Aundra J Duncan, SLPD, CCC-SLP
- Speech-Language Pathologist
- Port Wentworth, GA
National Provider Identifier
1780190256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP009850
- Practice address
- 2 Lake Shore Blvd
Port Wentworth, GA 31407-3610 - Phone
- (912) 417-6302
- NPI assigned
- Dec 20, 2017
- Last updated
- Dec 13, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP009850 | GA | Primary |
Addresses
Primary practice location
2 Lake Shore Blvd
Port Wentworth, GA 31407-3610
Mailing address
105 Danielle Loop
Rincon, GA 31326-8115
Phone (478) 550-8876
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP009850 | GA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734048000000",
"number": "1780190256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 DANIELLE LOOP",
"city": "RINCON",
"state": "GA",
"postal_code": "313268115",
"telephone_number": "478-550-8876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 LAKE SHORE BLVD",
"city": "PORT WENTWORTH",
"state": "GA",
"postal_code": "314073610",
"telephone_number": "912-417-6302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNCAN",
"first_name": "AUNDRA",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "SLPD, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-20",
"last_updated": "2024-12-13",
"certification_date": "2024-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "SLP009850",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Wentworth, GA
- Angel Clark-Kennedy
- Amanda Clementz, PT
- Latoya Sophia Cooper
- Dr Kenneith Durden Outreach
- Addie Elaine Duncan, DPT
- Kenneith Durden, LPC
- Effingham Hospital, Inc. (Effingham Occupational Medicine)
- Effingham Hospital, Inc. (Effingham Family Medicine at Port Wentworth)
- Elevate Applied Behavior Analysis Consulting LLC (Elevate ABA Consulting LLC)
- Exceptional Medical Services LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.