Individual provider Active NPI

Elizabeth Anne Taddonio, CCC-SLP

  • Speech-Language Pathologist
  • Watkinsville, GA
National Provider Identifier
1023536901
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP009853 Issued in GA
Practice address
1305 Jennings Mill Rd
Watkinsville, GA 30677-7238
Phone
(706) 552-1900
NPI assigned
Aug 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 SLP009853 GA Primary

Addresses

Primary practice location

1305 Jennings Mill Rd
Watkinsville, GA 30677-7238

Mailing address

1305 Jennings Mill Rd
Watkinsville, GA 30677-7238

Other practice location 1

1199 Prince Ave
Athens, GA 30606-2797
Phone (706) 475-7000

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
SLP009853GAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1023536901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 JENNINGS MILL RD",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306777238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 JENNINGS MILL RD",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306777238",
            "telephone_number": "706-552-1900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1199 Prince Ave",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306062797",
            "country_code": "US",
            "telephone_number": "706-475-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TADDONIO",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-31",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP009853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watkinsville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.