Active NPI
Gaetane Ferdinand Borders, ED.S.
- School Psychologist
- Snellville, GA
National Provider Identifier
1861905770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 700653
- Practice address
- 4060 Kittery PT
Snellville, GA 30039-3119 - Phone
- (404) 202-3040
- NPI assigned
- Nov 14, 2017
- Last updated
- Jan 8, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 700653 | GA | Primary |
Addresses
Primary practice location
4060 Kittery PT
Snellville, GA 30039-3119
Mailing address
4060 Kittery PT
Snellville, GA 30039-3119
Phone (404) 202-3040
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 700653 | GA | MD | School Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beautiful Dreamers | Multi-Specialty | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610064000000",
"number": "1861905770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4060 KITTERY PT",
"city": "SNELLVILLE",
"state": "GA",
"postal_code": "300393119",
"telephone_number": "404-202-3040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4060 KITTERY PT",
"city": "SNELLVILLE",
"state": "GA",
"postal_code": "300393119",
"telephone_number": "404-202-3040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORDERS",
"first_name": "GAETANE",
"middle_name": "FERDINAND",
"name_prefix": "Ms.",
"credential": "ED.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-14",
"last_updated": "2021-01-08",
"certification_date": "2021-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, School",
"state": "GA",
"license": "700653",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Snellville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.