Active NPI
Mallory Duey
- Speech-Language Pathologist
- Flint, MI
National Provider Identifier
1003317827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7101000302
- Practice address
- 5402 Gateway Ctr Ste B
Flint, MI 48507-3918 - Phone
- (810) 603-0040
- NPI assigned
- Feb 27, 2018
- 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 | 7101000302 | MI | Primary |
Addresses
Primary practice location
5402 Gateway Ctr Ste B
Flint, MI 48507-3918
Mailing address
5402 Gateway Ctr Ste B
Flint, MI 48507-3918
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221222001243 | MI | Practitioner - Qualified Speech Language Pathologist | 2062882657 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7101000302 | MI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519689600000",
"number": "1003317827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5402 GATEWAY CTR STE B",
"city": "FLINT",
"state": "MI",
"postal_code": "485073918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5402 GATEWAY CTR STE B",
"city": "FLINT",
"state": "MI",
"postal_code": "485073918",
"telephone_number": "810-603-0040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUEY",
"first_name": "MALLORY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-27",
"last_updated": "2018-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MI",
"license": "7101000302",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.