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

Sex

Female

Sole proprietor

No

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.

• Breakthrough Physical Therapy

  • Physical Therapist
  • Amory, MS
  • NPI 1396522736

  MS

  Medicare reassignment Care Compare group NPD
• Breakthrough Physical Therapy

  • Physical Therapist
  • Nettleton, MS
  • NPI 1144159294

  Speech-Language Pathologist

  NPD (past)

Specialty

Qualified Speech Language Pathologist

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Breakthrough Physical Therapy 9 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 8, 2024.

{
    "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

• All providers in Amory, MS
• 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.