Madison McCollum

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

S-4930 Issued in MS

Practice address

60368 Cotton Gin Port Rd
Amory, MS 38821-9104

Phone

(662) 257-3669

Fax

(662) 257-3961

NPI assigned

Oct 8, 2024

Last updated

Oct 8, 2024By 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

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Breakthrough Physical TherapyGroup PAC ID 3971959099, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Breakthrough Physical Therapy

  • Physical Therapist
  • Amory, MS
  • NPI 1396522736
  Medicare reassignment Care Compare group NPD
• Breakthrough Physical Therapy

  • Physical Therapist
  • Nettleton, MS
  • NPI 1144159294

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1728345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1902625718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60368 COTTON GIN PORT RD",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "388219104",
            "telephone_number": "662-257-3669",
            "fax_number": "662-257-3961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60368 COTTON GIN PORT RD",
            "city": "AMORY",
            "state": "MS",
            "postal_code": "388219104",
            "telephone_number": "662-257-3669",
            "fax_number": "662-257-3961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLUM",
        "first_name": "MADISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-08",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S-4930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magnolia Mobile Home Care LLC
• Main Street Drugs, LLC
• Jerry K Martin Jr., M.D.
• Shelby Maxcy, PHARM D.
• Emily B McCafferty, PT
• William Dwight McComb, MD
• Andrew Harrell McDonald, O.D.
• Michael T. McDonald, D.D.S.
• Kamryn Breyan McIntosh, FNP-C
• John R McPherson, MD

• Speech-Language Pathologist in Amory, MS
• Providers in Amory, MS by specialty
• Speech-Language Pathologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.