Individual provider Active NPI

Cynthia Miller

  • Speech-Language Pathologist
  • Newnan, GA
National Provider Identifier
1992429344
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP008879 Issued in GA
Practice address
2280 U.S. 29
Newnan, GA 30265
Phone
(770) 683-6833
NPI assigned
Sep 29, 2022
Last updated
Sep 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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 SLP008879 GA Primary

Addresses

Primary practice location

2280 U.S. 29
Newnan, GA 30265

Mailing address

94 Wall St
Waco, GA 30182-2418

Other practice location 1

94 Wall St
Waco, GA 30182-2418
Phone (770) 856-2859

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221227000685 GA Practitioner - Qualified Speech Language Pathologist 0547630022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Functional Pathways Preferred of Tennessee LLCGroup PAC ID 2860649654, 194 clinicians

Practice addresses (Care Compare)

2280 Hwy 29 N
Newnan, GA 30265-1031
Phone (888) 531-2204

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SLP008879GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Pathways Preferred of Tennessee LLC Speech-Language Pathologist CurrentSince Oct 1, 2022 Accepting new patients

Locations

2280 Highway 29 N
Newnan, GA 30265
Phone (770) 683-6833

10133 Sherrill Blvd
Ste 200
Knoxville, TN 37932
Phone (865) 392-2849

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1664409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1992429344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 WALL ST",
            "city": "WACO",
            "state": "GA",
            "postal_code": "301822418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2280 U.S. 29",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "30265",
            "telephone_number": "770-683-6833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "94 Wall St",
            "address_purpose": "LOCATION",
            "city": "Waco",
            "state": "GA",
            "postal_code": "301822418",
            "country_code": "US",
            "telephone_number": "770-856-2859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "CYNTHIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-29",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP008879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.