Active NPI
Virginia Rand, MED CCC-SLP
- Speech-Language Pathologist
- Decatur, GA
National Provider Identifier
1881030971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP005762
- Practice address
- 2622 McKinnon Dr
Decatur, GA 30030-4539 - Phone
- (678) 429-3790
- Fax
- (678) 279-5430
- NPI assigned
- May 15, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP005762 | GA | Primary |
Addresses
Primary practice location
2622 McKinnon Dr
Decatur, GA 30030-4539
Mailing address
2622 McKinnon Dr
Decatur, GA 30030-4539
Phone (678) 429-3790
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 764935686C | Medicaid | GA |
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP005762 | GA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rand Speech Pathology LLC | Speech-Language Pathologist | Current | Accepting new patients |
Locations
1954 Airport Rd
Ste 209
Chamblee, GA 30341
2107 N Decatur Rd
Decatur, GA 30033
Phone (404) 981-1699
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574294400000",
"number": "1881030971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2622 MCKINNON DR",
"city": "DECATUR",
"state": "GA",
"postal_code": "300304539",
"telephone_number": "678-429-3790",
"fax_number": "678-279-5430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2622 MCKINNON DR",
"city": "DECATUR",
"state": "GA",
"postal_code": "300304539",
"telephone_number": "678-429-3790",
"fax_number": "678-279-5430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAND",
"first_name": "VIRGINIA",
"credential": "MED CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-15",
"last_updated": "2019-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "SLP005762",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "764935686C",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.