Sara Coleman – Speech-Language Pathologist

Key facts

NPI: 1891455028
Entity type: Individual (NPI type 1)
Primary specialty: Speech-Language Pathologist 235Z00000X
License: SLP009118 (GA)
Practice address: 1110 S Pierce St Ste a
Alma, GA 31510-3718
Phone: (912) 342-8875
Fax: (912) 342-8016
NPI assigned: Dec 29, 2021
Sex: Female
Sole proprietor: Yes

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.

Pediatric Therapies of SE Ga, LLC Pediatric Occupational Therapist · Brunswick, GA · NPI 1841577111

NPD (past) SPEECH-LANGUAGE PATHOLOGIST

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Master of Education

State licenses

License	State	Type	Specialty
SLP009118	GA	MD	Speech-Language Pathologist

Practice roles

Organization	Specialty	Status	New patients
Pediatric Therapies of SE Ga, LLC	Speech-Language Pathologist	Past since Jan 2, 2022	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Speech-Language Pathologist	235Z00000X	SLP009118	GA	Yes

Addresses

Primary practice location

1110 S Pierce St Ste a
Alma, GA 31510-3718

Mailing address

4212 Coral Park Dr
Brunswick, GA 31520-3016
Phone (912) 342-8875

Other names

Sara Smith Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 29, 2021.

{
    "created_epoch": "1640736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1891455028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4212 CORAL PARK DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315203016",
            "telephone_number": "912-342-8875",
            "fax_number": "912-342-8016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 S PIERCE ST STE A",
            "city": "ALMA",
            "state": "GA",
            "postal_code": "315103718",
            "telephone_number": "912-342-8875",
            "fax_number": "912-342-8016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "SARA",
        "credential": "MED, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-29",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP009118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "SMITH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alma, GA

All providers in Alma, GA · Speech-Language Pathologist in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 29, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.