Active NPI
Carlie Bouldin, MS, CCC-SLP
- Speech-Language Pathologist
- Spanish Fort, AL
National Provider Identifier
1003286741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 3847
- Practice address
- 500 Spanish Fort Blvd
Spanish Fort, AL 36527-5018 - Phone
- (251) 626-8526
- Fax
- (251) 626-4878
- NPI assigned
- Oct 6, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 3847 | AL | Primary |
Addresses
Primary practice location
500 Spanish Fort Blvd
Spanish Fort, AL 36527-5018
Mailing address
245 Cahaba Valley Pkwy
Ste. 200
Pelham, AL 35124-2216
Phone (205) 942-6820
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3847 | AL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444089600000",
"number": "1003286741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "245 CAHABA VALLEY PKWY",
"address_2": "STE. 200",
"city": "PELHAM",
"state": "AL",
"postal_code": "351242216",
"telephone_number": "205-942-6820",
"fax_number": "205-314-7222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 SPANISH FORT BLVD",
"city": "SPANISH FORT",
"state": "AL",
"postal_code": "365275018",
"telephone_number": "251-626-8526",
"fax_number": "251-626-4878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOULDIN",
"first_name": "CARLIE",
"credential": "MS, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-06",
"last_updated": "2015-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AL",
"license": "3847",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spanish Fort, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.