Active NPI
Lane Roberts Rials, M.S., CCC-SLP
- Speech-Language Pathologist
- Buford, GA
National Provider Identifier
1912071176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP006547
- Practice address
- 4530 Nelson Brogdon Blvd Ste C
Buford, GA 30518 - Phone
- (678) 820-9606
- Fax
- (844) 820-9616
- NPI assigned
- Nov 20, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | PCET001077 | GA | |
| Speech-Language Pathologist | 235Z00000X | |||
| Speech-Language Pathologist | 235Z00000X | SLP006547 | GA | Primary |
Addresses
Primary practice location
4530 Nelson Brogdon Blvd Ste C
Buford, GA 30518
Mailing address
4530 Nelson Brogdon Blvd Ste C
Buford, GA 30518-5407
Phone (678) 820-9606
Other practice location 1
3615 Braselton Highway
Suite 103
Dacula, GA 30019-5907
Phone (678) 377-9634
Other practice location 2
3615 Braselton Highway
Suite 103
Dacula, GA 30019-5907
Phone (678) 377-9634
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PCET001077 | GA | MD | Speech-Language Pathologist |
| SLP006547 | GA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Motor Mouth Therapy, LLC | Speech-Language Pathologist | 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 and National Provider Directory roles.
-
dba Motor Mouth Therapy Services
- Speech-Language Pathologist
- Buford, GA
- NPI 1316372659
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551744000000",
"number": "1912071176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4530 NELSON BROGDON BLVD STE C",
"city": "BUFORD",
"state": "GA",
"postal_code": "305185407",
"telephone_number": "678-820-9606",
"fax_number": "844-820-9616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4530 NELSON BROGDON BLVD STE C",
"city": "BUFORD",
"state": "GA",
"postal_code": "30518",
"telephone_number": "678-820-9606",
"fax_number": "844-820-9616"
}
],
"practiceLocations": [
{
"address_1": "3615 Braselton Highway",
"address_2": "Suite 103",
"address_purpose": "LOCATION",
"city": "Dacula",
"state": "GA",
"postal_code": "300195907",
"country_code": "US",
"telephone_number": "678-377-9634",
"fax_number": "678-377-9609",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3615 Braselton Highway",
"address_2": "Suite 103",
"address_purpose": "LOCATION",
"city": "Dacula",
"state": "GA",
"postal_code": "300195907",
"country_code": "US",
"telephone_number": "678-377-9634",
"fax_number": "678-377-9609",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RIALS",
"first_name": "LANE",
"middle_name": "ROBERTS",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-20",
"last_updated": "2019-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "PCET001077",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "SLP006547",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Buford, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.