NPIMap

Individual provider Active NPI

Melanie Reilly, CCC-SLP

  • Speech-Language Pathologist
  • Gainesville, GA
National Provider Identifier
1962060350
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP010611 Issued in GA
Practice address
500 Spring St SE Ste 101
Gainesville, GA 30501-3773
Phone
(770) 615-7676
NPI assigned
May 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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 SLP010611 GA Primary

Addresses

Primary practice location

500 Spring St SE Ste 101
Gainesville, GA 30501-3773

Mailing address

4214 Mountain Ridge Rd
Gainesville, GA 30506-7341
Phone (570) 851-9199

Other practice location 1

9680 Crestview Ter
Gainesville, GA 30506-6768
Phone (470) 252-6656

Other names 1

  • Melanie Abda Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SLP010611GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Brannon Pediatric Services, Inc. Past Accepting new patients
M&M Speech and Feeding Services, LLC. Speech-Language Pathologist Past Accepting new patients
Lifting Spirits Therapy Services, Inc Past Accepting new patients

Organizations & group practices 3

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": "1559260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1962060350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4214 MOUNTAIN RIDGE RD",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305067341",
            "telephone_number": "570-851-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SPRING ST SE STE 101",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013773",
            "telephone_number": "770-615-7676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9680 Crestview Ter",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305066768",
            "country_code": "US",
            "telephone_number": "470-252-6656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REILLY",
        "first_name": "MELANIE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-31",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP010611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELANIE",
            "last_name": "ABDA",
            "credential": "CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.