Individual provider Active NPI

Benicia Malone

  • Clinical Exercise Physiologist
  • McDonough, GA
National Provider Identifier
1306740550
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Exercise PhysiologistTaxonomy code 224Y00000X
License
2017943 Issued in GA
Practice address
480 Ashton Cir
McDonough, GA 30253-8909
Phone
(470) 330-6888
NPI assigned
Oct 2, 2026
Last updated
Oct 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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.

Verify at the official NPI Registry.