Active NPI
Jill Shults, MMSC-CCC/SPEECH PATH
- Speech-Language Pathologist
- Roswell, GA
National Provider Identifier
1932433216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP000711
- Practice address
- 5910 Plantation Dr
Roswell, GA 30075-2866 - Phone
- (678) 234-9779
- NPI assigned
- Sep 20, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 | SLP000711 | GA | Primary |
Addresses
Primary practice location
5910 Plantation Dr
Roswell, GA 30075-2866
Mailing address
5910 Plantation Dr
Roswell, GA 30075-2866
Phone (678) 234-9779
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 |
|---|---|---|---|
| SLP000711 | GA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253404800000",
"number": "1932433216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5910 PLANTATION DR",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300752866",
"telephone_number": "678-234-9779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5910 PLANTATION DR",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300752866",
"telephone_number": "678-234-9779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHULTS",
"first_name": "JILL",
"credential": "MMSC-CCC/SPEECH PATH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-09-20",
"last_updated": "2009-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "SLP000711",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roswell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.