Active NPI
Elise R Marlowe
- Speech-Language Pathologist
- Tyrone, GA
National Provider Identifier
1912787995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- PCET003942
- Practice address
- 1130 Senoia Rd Ste A1
Tyrone, GA 30290-1640 - Phone
- (678) 632-6765
- Fax
- (678) 550-7931
- NPI assigned
- Oct 5, 2023
- 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 | PCET003942 | GA | Primary |
Addresses
Primary practice location
1130 Senoia Rd Ste A1
Tyrone, GA 30290-1640
Mailing address
1130 Senoia Rd Ste A1
Tyrone, GA 30290-1640
Phone (678) 632-6765
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
| License | State | Type | Specialty |
|---|---|---|---|
| PCET003942 | GA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Activekidz and Adult Therapy Services | 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.
-
- Physical Therapist
- Monroe, GA
- NPI 1326120932
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696464000000",
"number": "1912787995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1130 SENOIA RD STE A1",
"city": "TYRONE",
"state": "GA",
"postal_code": "302901640",
"telephone_number": "678-632-6765",
"fax_number": "678-550-7931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 SENOIA RD STE A1",
"city": "TYRONE",
"state": "GA",
"postal_code": "302901640",
"telephone_number": "678-632-6765",
"fax_number": "678-550-7931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARLOWE",
"first_name": "ELISE",
"middle_name": "R",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-05",
"last_updated": "2023-10-05",
"certification_date": "2023-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "PCET003942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyrone, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.