Individual provider Active NPI

Cindy Marie O'Neal, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Grovetown, GA
National Provider Identifier
1902017791
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146007366 Issued in IL
Practice address
314 Brentford Ave
Grovetown, GA 30813-4261
Phone
(563) 271-3330
NPI assigned
May 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146007366 IL Primary

Addresses

Primary practice location

314 Brentford Ave
Grovetown, GA 30813-4261

Mailing address

314 Brentford Ave
Grovetown, GA 30813-4261
Phone (563) 271-3330

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160628001782 GA Practitioner - Qualified Speech Language Pathologist 5597056291 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
146007366ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Speech-Language Pathologist CurrentSince Apr 8, 2016 Accepting new patients
Aegis Group Practice LLC Speech-Language Pathologist Current Accepting new patients
Aegis Group Practice LLC Speech-Language Pathologist CurrentSince Apr 8, 2016 Accepting new patients
Csra Therapy Services Inc Speech-Language Pathologist Past Accepting new patients

Locations

5690 State Bridge Rd
#9013
Johns Creek, GA 30022
Phone (770) 591-6583

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1902017791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 BRENTFORD AVE",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308134261",
            "telephone_number": "563-271-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 BRENTFORD AVE",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308134261",
            "telephone_number": "563-271-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEAL",
        "first_name": "CINDY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146007366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grovetown, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; 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.