Individual provider Active NPI

Janelle Eloise Bingham, CCC-SLP

  • Speech-Language Pathologist
  • Decatur, GA
National Provider Identifier
1184840308
Registry record updated Mar 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP008593 Issued in GA
Practice address
4535 Flat Shoals Pkwy
Suite 301
Decatur, GA 30034-5039
Phone
(704) 877-7710
NPI assigned
Apr 17, 2007
Last updated
Mar 3, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 016472 NY
Speech-Language Pathologist 235Z00000X 7687 NC
Speech-Language Pathologist 235Z00000X SLP008593 GA Primary

Addresses

Primary practice location

4535 Flat Shoals Pkwy
Suite 301
Decatur, GA 30034-5039

Mailing address

1090 Montclair Way
Snellville, GA 30078-7323
Phone (704) 877-7710

Other identifiers 2

IdentifierTypeStateIssuer
7412765MedicaidNC
146A7OtherNCBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240620000467 GA Practitioner - Qualified Speech Language Pathologist 6406399385 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7687NCMDMental Health Counselor
016472NYMDOccupational Therapist
SLP008593GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Expressable Therapy PC Speech-Language Pathologist CurrentSince Jun 10, 2024 Accepting new patients

Locations

5555 Glenridge Connector
Sandy Springs, GA 30342
Phone (202) 276-9478

5555 Glenridge Connector
Ste 200
Sandy Springs, GA 30342
Phone (404) 459-2516

7600 Chevy Chase Dr
Austin, TX 78752
Phone (512) 649-3880

7600 Chevy Chase Dr
Ste 300
Austin, TX 78752
Phone (512) 318-2503

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425340800000",
    "number": "1184840308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 MONTCLAIR WAY",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300787323",
            "telephone_number": "704-877-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4535 FLAT SHOALS PKWY",
            "address_2": "SUITE 301",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300345039",
            "telephone_number": "704-877-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BINGHAM",
        "first_name": "JANELLE",
        "middle_name": "ELOISE",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2015-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "016472",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "7687",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP008593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7412765",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "146A7",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.