Individual provider Active NPI

Danielle Mullendore, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Hagerstown, MD
National Provider Identifier
1104395045
Registry record updated Nov 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
05775 Issued in MD
Practice address
10435 Downsville Pike
Hagerstown, MD 21740-1732
Phone
(301) 766-2800
NPI assigned
Nov 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2018

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 05775 MD Primary

Addresses

Primary practice location

10435 Downsville Pike
Hagerstown, MD 21740-1732

Mailing address

9415 Morning Walk Dr
Hagerstown, MD 21740-1479
Phone (410) 302-9217

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

LicenseStateTypeSpecialty
05775MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Washington County Early Intervention Speech-Language Pathologist PastSince Sep 12, 2021 Accepting new patients
Board of Education of Washington County Speech-Language Pathologist PastSince Sep 12, 2021 Accepting new patients

Organizations & group practices 2

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": "1542758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542758400000",
    "number": "1104395045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9415 MORNING WALK DR",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217401479",
            "telephone_number": "410-302-9217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10435 DOWNSVILLE PIKE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217401732",
            "telephone_number": "301-766-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLENDORE",
        "first_name": "DANIELLE",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-21",
        "last_updated": "2018-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "05775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2018; 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.