Individual provider Active NPI

Emily Bennett Barefield, CCC-SLP

  • Speech-Language Pathologist
  • Waycross, GA
National Provider Identifier
1629692686
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP011424 Issued in GA
Practice address
303 Pineview Dr
Waycross, GA 31501-5229
Phone
(912) 283-0777
NPI assigned
Jun 4, 2020
Last updated
Apr 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X PCET003093 GA
Speech-Language Pathologist 235Z00000X SLP011424 GA Primary

Addresses

Primary practice location

303 Pineview Dr
Waycross, GA 31501-5229

Mailing address

6338 Riverwoods Dr
Blackshear, GA 31516-4661
Phone (912) 614-4774

Other names 1

  • Emily Anne Bennett Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210707001674 GA Practitioner - Qualified Speech Language Pathologist 9537561089 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PCET003093GAMDSpeech-Language Pathologist
SLP011424GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speech Clinic LLC Speech-Language Pathologist CurrentSince Jun 1, 2021 Accepting new patients
Speech-Language Pathology Contractors, Inc. Speech-Language Pathologist PastSince Jun 7, 2020 Accepting new patients

Locations

106 Shoppers Way
Ste 112
Brunswick, GA 31525
Phone (912) 554-3805

1507 Alice St
Waycross, GA 31501
Phone (912) 283-7220

303 Pineview Dr
Waycross, GA 31501
Phone (912) 283-0777

Organizations & group practices 2

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": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1629692686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6338 RIVERWOODS DR",
            "city": "BLACKSHEAR",
            "state": "GA",
            "postal_code": "315164661",
            "telephone_number": "912-614-4774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 PINEVIEW DR",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315015229",
            "telephone_number": "912-283-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAREFIELD",
        "first_name": "EMILY",
        "middle_name": "BENNETT",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-04",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "PCET003093",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP011424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "BENNETT",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waycross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.