Individual provider Active NPI

Cassondra Elaine Greene, CF-SLP

  • Speech-Language Pathologist
  • Dawsonville, GA
National Provider Identifier
1093228371
Registry record updated Nov 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
PCET003758 Issued in GA
Practice address
477 Prominence CT Ste 100
Dawsonville, GA 30534-6377
Phone
(401) 216-9564
NPI assigned
Nov 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2024

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 PCET003758 GA Primary

Addresses

Primary practice location

477 Prominence CT Ste 100
Dawsonville, GA 30534-6377

Mailing address

273 Quillian St
Cleveland, GA 30528-1464
Phone (706) 242-8247

Other practice location 1

273 Quillian St
Cleveland, GA 30528-1464
Phone (706) 865-6800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cgreene@soaringtlc.com Direct

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
PCET003758GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Prosper Therapy Services, LLC Speech-Language Pathologist CurrentSince Nov 17, 2024 Accepting new patients
Riverkids Houston Therapy, LLC PastSince Sep 23, 2024 Accepting new patients

Locations

477 Prominence Ct
Ste 100
Dawsonville, GA 30534
Phone (401) 216-9564

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731196800000",
    "number": "1093228371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "273 QUILLIAN ST",
            "city": "CLEVELAND",
            "state": "GA",
            "postal_code": "305281464",
            "telephone_number": "706-242-8247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 PROMINENCE CT STE 100",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305346377",
            "telephone_number": "401-216-9564"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "273 Quillian St",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "GA",
            "postal_code": "305281464",
            "country_code": "US",
            "telephone_number": "706-865-6800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREENE",
        "first_name": "CASSONDRA",
        "middle_name": "ELAINE",
        "credential": "CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-09",
        "last_updated": "2024-11-10",
        "certification_date": "2024-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "PCET003758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cgreene@soaringtlc.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "273 Quillian St",
            "city": "Cleveland",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305281464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dawsonville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2024; 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.