Individual provider Active NPI

Octavia Elizabeth Cherry, SLP

  • Speech-Language Pathologist
  • Atlanta, GA
National Provider Identifier
1881284685
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP011776 Issued in GA
Practice address
707 Park Ave NE
Atlanta, GA 30326-3401
Phone
(414) 213-6601
NPI assigned
Jan 25, 2021
Last updated
Sep 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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 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

Enrollment IDStateProvider typePAC IDDetails
I20220222001505 GA Practitioner - Qualified Speech Language Pathologist 7315331188 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Transperfect Health CorpGroup PAC ID 3173982287, 33 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

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

LicenseStateTypeSpecialty
242005894ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince Jan 27, 2025 Accepting new patients
Legacy Healthcare Services, Inc. Speech-Language Pathologist CurrentSince Jan 27, 2025 Accepting new patients
Time to Sprout Speech and Language Services, LLC Speech-Language Pathologist CurrentSince Sep 5, 2023 Accepting new patients
Legacy Healthcare Services, Inc. Speech-Language Pathologist CurrentSince Jan 27, 2025 Accepting new patients
Onr National Speech Pathology Inc CurrentSince Jan 25, 2022 Accepting new patients
Zucker & Zucker PC PastSince Jan 1, 2021 Accepting new patients
Residential Alternatives of Illinois, Inc. PastSince Jan 1, 2021 Accepting new patients
Landmark Speech and Language Services, LLC Speech-Language Pathologist PastSince Oct 16, 2022 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.

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.

Verify at the official NPI Registry.