Individual provider Active NPI

Angela M. C. Schmoldt, M.A. CCC-SLP

  • Speech-Language Pathologist
  • Tallahassee, FL
National Provider Identifier
1013178003
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1961 Issued in WV
Practice address
1425 Village Square Blvd
Suite 3
Tallahassee, FL 32312-1271
Phone
(850) 431-4445
Fax
(850) 431-6231
NPI assigned
Jun 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP.10209 OH
Speech-Language Pathologist 235Z00000X SA 11264 FL
Speech-Language Pathologist 235Z00000X 1961 WV Primary

Addresses

Primary practice location

1425 Village Square Blvd
Suite 3
Tallahassee, FL 32312-1271

Mailing address

201 Bakers Ridge Rd
Morgantown, WV 26508-1500
Phone (043) 598-4000

Other identifiers 1

IdentifierTypeStateIssuer
0028740MedicaidOH

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 Arts

State licenses

LicenseStateTypeSpecialty
SA 11264FLMDSpeech-Language Pathologist
SP.10209OHMDSpeech-Language Pathologist
1961WVMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Hospitals, Inc Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1013178003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 BAKERS RIDGE RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265081500",
            "telephone_number": "043-598-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 VILLAGE SQUARE BLVD",
            "address_2": "SUITE 3",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323121271",
            "telephone_number": "850-431-4445",
            "fax_number": "850-431-6231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMOLDT",
        "first_name": "ANGELA",
        "middle_name": "M. C.",
        "name_prefix": "Ms.",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.10209",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 11264",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WV",
            "license": "1961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0028740",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; 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.