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Kendall Jackson , SLP

Speech-Language Pathologist β€’ East Point, GA

Active NPI 1477818342 Individual Practitioner Female Practitioner
Practice location in NPPES

3485 N Desert Dr Ste 105
East Point, GA 303445724

Call 6787247033 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

3485 N Desert Dr Ste 105

East Point, GA 303445724

Telephone 6787247033
Fax 6783027357
Organization at the Same NPPES Address or Phone
Bright Future Therapy Services Facility NPI 1346046349

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2012

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in East Point and Georgia

23 active clinicians are listed under Speech-Language Pathologist with a practice address in East Point, GA (4,745 in Georgia).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in East Point

0% of these 23 clinicians have the CMS telehealth indicator.

8.7% of these 23 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-08-18
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

License # reported to NPPES GA SLP008103

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Georgia Composite Medical Board.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
003126519G (GA)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

10 Historical Events
πŸ“
Updated Practice Location August 18, 2023

Registered at 3485 N DESERT DR STE 105, EAST POINT, GA 303445724 (Tel: 6787247033)

πŸ“
Updated Practice Location November 29, 2019

Registered at 3460 SOMERSET TRL SW, ATLANTA, GA 303317935 (Tel: 8643237445)

πŸ“
Updated Business Mailing Address November 29, 2019

Registered at 3460 SOMERSET TRL SW, ATLANTA, GA 303317935 (Tel: 8643237445)

πŸ‘€
Provider Name / Credentials Updated November 29, 2019

Recorded as KENDALL JACKSON, SLP

βœ…
NPI Profile Active February 12, 2013

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) February 12, 2013

Registered at 415 SYLVIA DR, H16, FOREST PARK, GA 302972918 (Tel: 8643237445)

πŸ“
Business Mailing Address (Initial Record) February 12, 2013

Registered at 415 SYLVIA DR, H16, FOREST PARK, GA 302972918 (Tel: 8643237445)

πŸ‘€
Provider Name / Credentials (Initial Record) February 12, 2013

Recorded as KENDALL JACKSON-MABIFAH, SLP

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 12, 2013

Speech-Language Pathologist (license number reported to NPPES: GA SLP008103)

🟒
Initial NPI Registration & Enumeration July 06, 2012

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1477818342
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 06, 2012
Last Update: August 18, 2023
Sole Proprietor: Yes

Mailing Address

3460 Somerset Trl Sw

Atlanta, GA 303317935

Phone: 8643237445

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.