Active NPI
Roxanne Fon
- Speech-Language Pathologist
- Atlanta, GA
National Provider Identifier
1992058382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 07019
- Practice address
- 1391 Collier Rd NW Apt 2108
Atlanta, GA 30318-7452 - Phone
- (404) 966-1075
- NPI assigned
- Oct 22, 2012
- 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 | 07019 | MD | Primary |
Addresses
Primary practice location
1391 Collier Rd NW Apt 2108
Atlanta, GA 30318-7452
Mailing address
207 13TH St NE Apt 1214
Atlanta, GA 30309-4593
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 |
|---|---|---|---|
| 07019 | MD | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617926400000",
"number": "1992058382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 13TH ST NE APT 1214",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303094593"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1391 COLLIER RD NW APT 2108",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303187452",
"telephone_number": "404-966-1075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FON",
"first_name": "ROXANNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-10-22",
"last_updated": "2021-04-09",
"certification_date": "2021-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": "07019",
"primary": true
}
],
"identifiers": [],
"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 Apr 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.