Individual provider Active NPI

Keri Mooney

  • Speech-Language Pathologist
  • Monroe, GA
National Provider Identifier
1942600226
Registry record updated Aug 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
PCET002096 Issued in GA
Practice address
1865 Bold Springs Rd NW
Monroe, GA 30656-4605
Phone
(770) 267-8677
NPI assigned
Aug 24, 2014
Last updated
Aug 24, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2014

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 PCET002096 GA Primary

Addresses

Primary practice location

1865 Bold Springs Rd NW
Monroe, GA 30656-4605

Mailing address

1865 Bold Springs Rd NW
Monroe, GA 30656-4605

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
PCET002096GAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1408838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408838400000",
    "number": "1942600226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1865 BOLD SPRINGS RD NW",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306564605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1865 BOLD SPRINGS RD NW",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306564605",
            "telephone_number": "770-267-8677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONEY",
        "first_name": "KERI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-24",
        "last_updated": "2014-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "PCET002096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2014; 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.