Active NPI
Joanne Renee Dibenedetto, CCC-SLP
- Speech-Language Pathologist
- Roswell, GA
National Provider Identifier
1801470646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP011126
- Practice address
- 1475 Holcomb Bridge Rd
Roswell, GA 30076-2139 - Phone
- (770) 645-5724
- NPI assigned
- May 7, 2021
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP011126 | GA | Primary |
Addresses
Primary practice location
1475 Holcomb Bridge Rd
Roswell, GA 30076-2139
Mailing address
716 First Cotton Dr
Powder Springs, GA 30127-6236
Phone (770) 312-3108
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP011126 | GA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620345600000",
"number": "1801470646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "716 FIRST COTTON DR",
"city": "POWDER SPRINGS",
"state": "GA",
"postal_code": "301276236",
"telephone_number": "770-312-3108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1475 HOLCOMB BRIDGE RD",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300762139",
"telephone_number": "770-645-5724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIBENEDETTO",
"first_name": "JOANNE",
"middle_name": "RENEE",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-07",
"last_updated": "2021-05-07",
"certification_date": "2021-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "SLP011126",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roswell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.