Individual provider Active NPI

Catherine Blair Parker

  • Speech-Language Pathologist
  • Leesburg, GA
National Provider Identifier
1851693949
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP007289 Issued in GA
Practice address
130 Veterinary Way Ste 3
Leesburg, GA 31763-5667
Phone
(229) 496-5222
Fax
(229) 219-7914
NPI assigned
Nov 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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 SLP007289 GA Primary

Addresses

Primary practice location

130 Veterinary Way Ste 3
Leesburg, GA 31763-5667

Mailing address

1021B Elm Ave
Americus, GA 31709-4229

Other identifiers 1

IdentifierTypeStateIssuer
003168471BMedicaidGA

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
SLP007289GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapyworks Pediatric Center LLC Speech-Language Pathologist CurrentSince Sep 25, 2022 Accepting new patients
Manor of Speaking, LLC Past Accepting new patients

Locations

130 Veterinary Way
Ste 3
Leesburg, GA 31763
Phone (229) 496-5222

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1290470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1851693949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021B ELM AVE",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317094229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 VETERINARY WAY STE 3",
            "city": "LEESBURG",
            "state": "GA",
            "postal_code": "317635667",
            "telephone_number": "229-496-5222",
            "fax_number": "229-219-7914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "CATHERINE",
        "middle_name": "BLAIR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-23",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP007289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003168471B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.