Active NPI
Octavia Elizabeth Cherry, SLP
- Speech-Language Pathologist
- Atlanta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP011776
- Practice address
- 707 Park Ave NE
Atlanta, GA 30326-3401 - Phone
- (414) 213-6601
- NPI assigned
- Jan 25, 2021
- Last updated
- Sep 5, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 242005894 | IL | |
| Speech-Language Pathologist | 235Z00000X | SLP011776 | GA | Primary |
Addresses
Primary practice location
707 Park Ave NE
Atlanta, GA 30326-3401
Mailing address
707 Park Ave NE
Atlanta, GA 30326-3401
Phone (414) 213-6601
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Legacy Healthcare Services Inc
Practice addresses (Care Compare)
1170 Peachtree St NE
Suite 1600
Atlanta, GA 30309-7674
Phone (570) 854-1632
2401 Cumberland Pkwy SE
Atlanta, GA 30339-1808
Phone (404) 446-3884
4005 S Cobb Dr
Smyrna, GA 30008
Phone (678) 239-4777
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 242005894 | IL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Healthcare Services Inc | Speech-Language Pathologist | Current | Accepting new patients |
| Legacy Healthcare Services, Inc. | Speech-Language Pathologist | Current | Accepting new patients |
| Time to Sprout Speech and Language Services, LLC | Speech-Language Pathologist | Current | Accepting new patients |
| Legacy Healthcare Services, Inc. | Speech-Language Pathologist | Current | Accepting new patients |
| Onr National Speech Pathology Inc | Current | Accepting new patients | |
| Zucker & Zucker PC | Past | Accepting new patients | |
| Residential Alternatives of Illinois, Inc. | Past | Accepting new patients | |
| Landmark Speech and Language Services, LLC | Speech-Language Pathologist | Past | Accepting new patients |
Locations
3333 E Cherokee Dr
Canton, GA 30115
Phone (470) 714-6698
110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (919) 861-2441
8500 Bluffstone Cv
Ste A201
Austin, TX 78759
Phone (512) 220-5252
Organizations & group practices 9
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.
-
- Physical Therapist
- Atlanta, GA
- NPI 1831801000
-
- Physical Therapist
- Dawsonville, GA
- NPI 1528419751
Speech-Language Pathologist
-
- Physical Therapist
- Winder, GA
- NPI 1831619337
Speech-Language Pathologist
-
dba ONR National, Inc.
- Rehabilitation Clinic/Center
- Kensington, MD
- NPI 1972965952
GA
-
- Speech-Language Pathologist
- Atlanta, GA
- NPI 1609652197
-
- Speech-Language Pathologist
- Atlanta, GA
- NPI 1861117095
-
- Physical Therapist
- Cary, NC
- NPI 1225879489
Speech-Language Pathologist
-
dba Manor Court of Peoria
- Skilled Nursing Facility
- Peoria, IL
- NPI 1700996972
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693872000000",
"number": "1881284685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 PARK AVE NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303263401",
"telephone_number": "414-213-6601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 PARK AVE NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303263401",
"telephone_number": "414-213-6601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHERRY",
"first_name": "OCTAVIA",
"middle_name": "ELIZABETH",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-25",
"last_updated": "2023-09-05",
"certification_date": "2023-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "242005894",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "SLP011776",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.