NPIMap

Organization Active NPI

Georgia Institute of Speech and Language

  • Speech-Language Pathologist
  • McDonough, GA
National Provider Identifier
1902497506
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
GEORGIA INSTITUTE OF SPEECH AND LANGUAGE
Practice address
112 Radcliffe Dr
McDonough, GA 30253-8371
Phone
(301) 825-4201
NPI assigned
Jan 27, 2021
Last updated
Mar 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Authorized official

Name
Rose Antoinette Matthews, M.S., CCC-SLPNPI 1871057414
Title
Owner/Speech Language Pathologist
Phone
(301) 825-4201

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

112 Radcliffe Dr
McDonough, GA 30253-8371

Mailing address

112 Radcliffe Dr
McDonough, GA 30253-8371
Phone (301) 825-4201

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1611705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711670400000",
    "number": "1902497506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 RADCLIFFE DR",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302538371",
            "telephone_number": "301-825-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 RADCLIFFE DR",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302538371",
            "telephone_number": "301-825-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA INSTITUTE OF SPEECH AND LANGUAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-27",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A",
        "authorized_official_last_name": "MATTHEWS",
        "authorized_official_first_name": "ROSE",
        "authorized_official_middle_name": "ANTOINETTE",
        "authorized_official_title_or_position": "OWNER/SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "301-825-4201",
        "authorized_official_credential": "M.S., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.