NPIMap

Organization Active NPI

Shining Star Therapy Services, LLC

  • Speech-Language Pathologist
  • Commerce, GA
National Provider Identifier
1861840647
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
SHINING STAR THERAPY SERVICES, LLC
Practice address
516 Oconee LN
Commerce, GA 30529-4182
Phone
(706) 491-5409
NPI assigned
Jun 2, 2016
Last updated
Sep 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Madison Johnson, M.ED. CCC-SLPNPI 1720336621
Title
Owner, Speech-Language Pathologist
Phone
(706) 491-5409

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

516 Oconee LN
Commerce, GA 30529-4182

Mailing address

516 Oconee LN
Commerce, GA 30529-4182

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1464825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726099200000",
    "number": "1861840647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 OCONEE LN",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "305294182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 OCONEE LN",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "305294182",
            "telephone_number": "706-491-5409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINING STAR THERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-02",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MADISON",
        "authorized_official_title_or_position": "OWNER, SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "706-491-5409",
        "authorized_official_credential": "M.ED. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.

Verify at the official NPI Registry.