Madilyn Slater, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

T-4765 Issued in MS

Practice address

611 Alcorn Dr
Corinth, MS 38834-9321

Phone

(662) 293-1000

NPI assigned

Jul 2, 2022

Last updated

Jul 2, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Madilyn Petty Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Interoperability endpoints

• Direct secure messaging: madilyn.slater@arcare.directbygreenway.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1656720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656720000000",
    "number": "1891428389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 HIGHLAND DR",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388343005",
            "telephone_number": "731-445-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 ALCORN DR",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349321",
            "telephone_number": "662-293-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLATER",
        "first_name": "MADILYN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-02",
        "last_updated": "2022-07-02",
        "certification_date": "2022-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "T-4765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADILYN",
            "last_name": "PETTY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Internal Medicine Physician in Corinth, MS
• Providers in Corinth, MS by specialty
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.