Individual provider Active NPI

Sandra D Williams, SLP

  • Speech-Language Pathologist
  • Atlanta, GA
National Provider Identifier
1922201961
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP004523 Issued in GA
Practice address
1200 Lake Hearn Dr NE
Suite 250
Atlanta, GA 30319
Phone
(404) 943-1070
Fax
(404) 943-0890
NPI assigned
Jun 7, 2007
Last updated
Aug 8, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP15942 CA
Speech-Language Pathologist 235Z00000X 1508 AL
Speech-Language Pathologist 235Z00000X SA10287 FL
Speech-Language Pathologist 235Z00000X 03951 MD
Speech-Language Pathologist 235Z00000X 109718 TX
Speech-Language Pathologist 235Z00000X 2202003292 VA
Speech-Language Pathologist 235Z00000X SLP004523 GA Primary

Addresses

Primary practice location

1200 Lake Hearn Dr NE
Suite 250
Atlanta, GA 30319

Mailing address

227 Charity Dr
Douglasville, GA 30134-6116
Phone (770) 947-8382

Other identifiers 1

IdentifierTypeStateIssuer
052177015OtherGADRIVERS LICENSE

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
1508ALMDProfessional Counselor
SP15942CAMDSpeech-Language Pathologist
SA10287FLMDSpeech-Language Pathologist
SLP004523GAMDSpeech-Language Pathologist
03951MDMDSpeech-Language Pathologist
109718TXMDSpeech-Language Pathologist
2202003292VAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1922201961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 CHARITY DR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301346116",
            "telephone_number": "770-947-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 LAKE HEARN DR NE",
            "address_2": "SUITE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30319",
            "telephone_number": "404-943-1070",
            "fax_number": "404-943-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SANDRA",
        "middle_name": "D",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP15942",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AL",
            "license": "1508",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA10287",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "03951",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "109718",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202003292",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP004523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "052177015",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; 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.