Active NPI
Benicia Malone
- Clinical Exercise Physiologist
- McDonough, GA
National Provider Identifier
1306740550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Exercise Physiologist
- License
- 2017943
- Practice address
- 480 Ashton Cir
McDonough, GA 30253-8909 - Phone
- (470) 330-6888
- NPI assigned
- Oct 2, 2026
- Last updated
- Oct 2, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Exercise Physiologist | 224Y00000X | 2017943 | GA | Primary |
Addresses
Primary practice location
480 Ashton Cir
McDonough, GA 30253-8909
Mailing address
480 Ashton Cir
McDonough, GA 30253-8909
Phone (470) 330-6888
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790899200000",
"number": "1306740550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "480 ASHTON CIR",
"city": "MCDONOUGH",
"state": "GA",
"postal_code": "302538909",
"telephone_number": "470-330-6888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "480 ASHTON CIR",
"city": "MCDONOUGH",
"state": "GA",
"postal_code": "302538909",
"telephone_number": "470-330-6888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALONE",
"first_name": "BENICIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-10-02",
"last_updated": "2026-10-02",
"certification_date": "2026-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "224Y00000X",
"taxonomy_group": "",
"desc": "Clinical Exercise Physiologist",
"state": "GA",
"license": "2017943",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in McDonough, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.