NPIMap

Individual provider Active NPI

Lakeisha Browder

  • Speech-Language Pathologist
  • Marietta, GA
National Provider Identifier
1861615544
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP003992 Issued in GA
Practice address
790 Oak Trail Dr
Marietta, GA 30062-7502
Phone
(770) 977-6866
Fax
(770) 977-6887
NPI assigned
Apr 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 SLP003992 GA Primary

Addresses

Primary practice location

790 Oak Trail Dr
Marietta, GA 30062-7502

Mailing address

790 Oak Trail Dr
Marietta, GA 30062-7502
Phone (770) 977-6866

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
SLP003992GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
North Georgia Pediatric Therapies, LLC Speech-Language Pathologist Past Accepting new patients
North Georgia Pediatric Therapies, LLC Speech-Language Pathologist Past Accepting new patients

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": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1861615544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 OAK TRAIL DR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300627502",
            "telephone_number": "770-977-6866",
            "fax_number": "770-977-6887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 OAK TRAIL DR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300627502",
            "telephone_number": "770-977-6866",
            "fax_number": "770-977-6887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWDER",
        "first_name": "LAKEISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP003992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.