Madison Mathenia, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

6794 Issued in TN

Practice address

2030 Chilhowee Medical Park
Maryville, TN 37804-5285

Phone

(865) 982-3400

Fax

(865) 238-2034

NPI assigned

Feb 13, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Little Tennessee Valley Educational Cooperative

  • Local Education Agency (LEA)
  • Loudon, TN
  • NPI 1114256039
  NPD (past)
• Speech Pathology Services of East Tennessee LLC

  • Rehabilitation Clinic/Center
  • Maryville, TN
  • NPI 1659466712

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565913600000",
    "number": "1144769985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5209",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378025209",
            "telephone_number": "865-982-3400",
            "fax_number": "865-238-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 CHILHOWEE MEDICAL PARK",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045285",
            "telephone_number": "865-982-3400",
            "fax_number": "865-238-2034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11613 SE 7th St",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986835265",
            "country_code": "US",
            "telephone_number": "360-936-1557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHENIA",
        "first_name": "MADISON",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-13",
        "last_updated": "2019-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "60678215",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "6794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q051047",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maryville Foot Clinic Inc
• Maryville Jamestown Opco LLC
• Maryville Massage
• Maryville Surgical Center
• Gary Merlin Mason, M.D.
• Sheena Mathes
• Lukas Mathews, MD
• Emily L Mathis, FNP
• Mara Maurer
• Megan Mayeux Smith, DPT

• Speech-Language Pathologist in Maryville, TN
• Providers in Maryville, TN by specialty
• Speech-Language Pathologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; 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.