Individual provider Active NPI

Anisha Patel, M.S.

  • Speech-Language Pathologist
  • Buford, GA
National Provider Identifier
1790276194
Registry record updated May 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP010115 Issued in GA
Practice address
22 Buford Village Way Ste 229
Buford, GA 30518-8846
Phone
(678) 482-6100
NPI assigned
May 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2018

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 SLP010115 GA Primary

Addresses

Primary practice location

22 Buford Village Way Ste 229
Buford, GA 30518-8846

Mailing address

2789 Bridle Ridge Way
Buford, GA 30519-7661
Phone (678) 372-6339

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SLP010115GAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1790276194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2789 BRIDLE RIDGE WAY",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305197661",
            "telephone_number": "678-372-6339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BUFORD VILLAGE WAY STE 229",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305188846",
            "telephone_number": "678-482-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "ANISHA",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-22",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP010115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buford, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; 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.