Individual provider Active NPI

Regina Susan Arvin, MS-SLP

  • Speech-Language Pathologist
  • Kennesaw, GA
National Provider Identifier
1821122771
Registry record updated Sep 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP001800 Issued in GA
Practice address
3720 Somerset RDG NW
Kennesaw, GA 30144-5716
Phone
(770) 427-8117
Fax
(770) 427-8117
NPI assigned
Mar 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2010

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 SLP001800 GA Primary

Addresses

Primary practice location

3720 Somerset RDG NW
Kennesaw, GA 30144-5716

Mailing address

3720 Somerset RDG NW
Kennesaw, GA 30144-5716
Phone (770) 427-8117

Other identifiers 1

IdentifierTypeStateIssuer
000687178EMedicaidGA

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
SLP001800GAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285545600000",
    "number": "1821122771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 SOMERSET RDG NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301445716",
            "telephone_number": "770-427-8117",
            "fax_number": "770-427-8117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 SOMERSET RDG NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301445716",
            "telephone_number": "770-427-8117",
            "fax_number": "770-427-8117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARVIN",
        "first_name": "REGINA",
        "middle_name": "SUSAN",
        "credential": "MS-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2010-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP001800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000687178E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; 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.