Individual provider Active NPI

Mary Allison Moody, M.ED., CF-SLP

  • Speech-Language Pathologist
  • Tallahassee, FL
National Provider Identifier
1013741370
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SZ12186 Issued in FL
Practice address
2365 Centerville Rd
Tallahassee, FL 32308-4317
Phone
(850) 212-2404
NPI assigned
Aug 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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 SZ12186 FL Primary

Addresses

Primary practice location

2365 Centerville Rd
Tallahassee, FL 32308-4317

Mailing address

2250 Bluff Oak Way Apt 115
Tallahassee, FL 32311-6164
Phone (912) 281-9543

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 Education

State licenses

LicenseStateTypeSpecialty
SZ12186FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1724889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1013741370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 BLUFF OAK WAY APT 115",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323116164",
            "telephone_number": "912-281-9543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2365 CENTERVILLE RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084317",
            "telephone_number": "850-212-2404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "MARY",
        "middle_name": "ALLISON",
        "name_prefix": "Mrs.",
        "credential": "M.ED., CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-29",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ12186",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 29, 2024; 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.