NPIMap

Organization Active NPI

Roswell Speech Therapy, LLC

  • Speech-Language Pathologist
  • Roswell, GA
National Provider Identifier
1992499479
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
ROSWELL SPEECH THERAPY, LLC
Practice address
5214 Walton Way
Roswell, GA 30076-3498
Phone
(678) 210-1764
NPI assigned
Jun 7, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Authorized official

Name
Mrs. Jessica Ginn Boehm, M.S. CCC-SLPNPI 1356714588
Title
Owner
Phone
(678) 210-1764

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

5214 Walton Way
Roswell, GA 30076-3498

Mailing address

5214 Walton Way
Roswell, GA 30076-3498
Phone (678) 210-1764

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1686096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686096000000",
    "number": "1992499479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5214 WALTON WAY",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300763498",
            "telephone_number": "678-210-1764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5214 WALTON WAY",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300763498",
            "telephone_number": "678-210-1764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSWELL SPEECH THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-07",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A",
        "authorized_official_last_name": "BOEHM",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "GINN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-210-1764",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "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 Jun 7, 2023; 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.