Individual provider Active NPI

Jamie S Hurst-Larson, SLP-CCC

  • Speech-Language Pathologist
  • Martinez, GA
National Provider Identifier
1912150871
Registry record updated Oct 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP003571 Issued in GA
Practice address
229 Hillbrook Dr
Martinez, GA 30907-1588
Phone
(706) 860-9385
Fax
(706) 868-5624
NPI assigned
Oct 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP003571 GA Primary

Addresses

Primary practice location

229 Hillbrook Dr
Martinez, GA 30907-1588

Mailing address

229 Hillbrook Dr
Martinez, GA 30907-1588
Phone (706) 860-9385

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

State licenses

LicenseStateTypeSpecialty
SLP003571GAMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224720000000",
    "number": "1912150871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 HILLBROOK DR",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309071588",
            "telephone_number": "706-860-9385",
            "fax_number": "706-868-5624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 HILLBROOK DR",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309071588",
            "telephone_number": "706-860-9385",
            "fax_number": "706-868-5624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURST-LARSON",
        "first_name": "JAMIE",
        "middle_name": "S",
        "credential": "SLP-CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-23",
        "last_updated": "2008-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP003571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinez, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; 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.