Individual provider Active NPI

Jennifer Scarborough Slade, PT

  • Physical Therapist
  • Griffin, GA
National Provider Identifier
1346492626
Registry record updated Oct 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT007331 Issued in GA
Practice address
670 S 8TH St
Griffin, GA 30224-4214
Phone
(770) 229-6498
Fax
(770) 229-6958
NPI assigned
Oct 17, 2008
Last updated
Oct 17, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT007331 GA Primary

Addresses

Primary practice location

670 S 8TH St
Griffin, GA 30224-4214

Mailing address

PO Box V
Griffin, GA 30224-0047
Phone (770) 229-6498

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230328002852 GA Practitioner - Physical Therapist in Private Practice 9739553017 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Weston Group IncGroup PAC ID 8123936796, 215 clinicians

Practice addresses (Care Compare)

1100 Reinhardt College Pkwy
Canton, GA 30114-2011
Phone (770) 721-2812

2400 Buford Dr
Lawrenceville, GA 30043-2570
Phone (470) 397-5953

2900 McEver Rd
Gainesville, GA 30504-5516
Phone (978) 940-1101

4055 Suwanee Dam Rd
Suwanee, GA 30024-4948
Phone (770) 766-0958

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT007331GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Rehabilitation, LLC Physical Therapist CurrentSince Apr 1, 2024 Accepting new patients
The Weston Group Inc. Physical Therapist CurrentSince Dec 13, 2022 Accepting new patients
The Weston Group Inc. Physical Therapist CurrentSince Dec 13, 2022 Accepting new patients
Select Outpatient Services Inc Physical Therapist PastSince Jan 1, 2017 Accepting new patients

Locations

1100 Reinhardt College Pkwy
Canton, GA 30114
Phone (770) 721-2812

Organizations & group practices 4

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": "1224201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224201600000",
    "number": "1346492626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX V",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302240047",
            "telephone_number": "770-229-6498",
            "fax_number": "770-229-6958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 S 8TH ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244214",
            "telephone_number": "770-229-6498",
            "fax_number": "770-229-6958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLADE",
        "first_name": "JENNIFER",
        "middle_name": "SCARBOROUGH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-17",
        "last_updated": "2008-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT007331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Griffin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.