Benita Madison, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP006366 Issued in GA

Practice address

3056 Anvil Block Rd Ste 118
Ellenwood, GA 30294-2864

Phone

(404) 366-8100

NPI assigned

Jun 10, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Undefined Non-Physician Type (Specify)

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Entelechy Rehab, LLCGroup PAC ID 0547549131, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Entelechy Rehab, LLC

  • Physical Therapy Clinic/Center
  • Conley, GA
  • NPI 1881063576
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1952561466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2898 SUMMIT DR",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302366247",
            "telephone_number": "404-664-2208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3056 ANVIL BLOCK RD STE 118",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302942864",
            "telephone_number": "404-366-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Lake Hearn Dr NE",
            "address_2": "Suite 250",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303191415",
            "country_code": "US",
            "telephone_number": "404-943-1070 x103",
            "fax_number": "404-943-0890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2898 Summit Dr",
            "address_purpose": "LOCATION",
            "city": "Jonesboro",
            "state": "GA",
            "postal_code": "302366247",
            "country_code": "US",
            "telephone_number": "404-664-2208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADISON",
        "first_name": "BENITA",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP006366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER'S LICENSE",
            "identifier": "049255437",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nikkia Lucas Hill, RRT
• Crystal V Lucas
• Cynthia Mack-McMorris
• Jameka Danielle Mack
• Kakethia S. Mack, NURSE PRACTITIONER
• April Marie F. Madu, D.O.
• Majestic Health Solutions
• Patricia Linette March, R.T.(R)
• Tatiana Marcus
• Sharalyn Marrion Martin, NP-C

• Speech-Language Pathologist in Ellenwood, GA
• Providers in Ellenwood, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.
• 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.