Claudeshia Pertilla, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP011229 Issued in GA

Practice address

316 E 16TH Ave Ste a
Cordele, GA 31015-1209

Phone

(229) 207-4004

Fax

(229) 394-0031

NPI assigned

Oct 16, 2021

Last updated

Oct 16, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Qualified Speech Language Pathologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwest Georgia Rehab, IncGroup PAC ID 6204966740, shared by 2 NPIs, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1634342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634342400000",
    "number": "1932862026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2760 EB HAMILTON DR APT 121",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317935050",
            "telephone_number": "229-296-7594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 E 16TH AVE STE A",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310151209",
            "telephone_number": "229-207-4004",
            "fax_number": "229-394-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERTILLA",
        "first_name": "CLAUDESHIA",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-16",
        "last_updated": "2021-10-16",
        "certification_date": "2021-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP011229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William P Pannell Jr., MD
• Joni Parkerson
• Carrie Lyn Parson, RNCPNP
• Susan Patel, PHARM D
• Taylor M Pearson, MED, CCC-SLP
• William Arthur Pflueger, O.D.
• Kethia Phelizor, DO
• Bobbi Amber Phillips
• Larisa Phillips
• Sandy Pierce

• Speech-Language Pathologist in Cordele, GA
• Providers in Cordele, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.