Active NPI
Kelly Mauldin, M.S., CCC-SLP
- Speech-Language Pathologist
- Red Bay, AL
National Provider Identifier
1124690748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- S-4833
- Practice address
- 106 10TH Ave NW
Red Bay, AL 35582-3800 - Phone
- (844) 653-0321
- NPI assigned
- Jul 13, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 4667 | AL | |
| Speech-Language Pathologist | 235Z00000X | S-4833 | MS | Primary |
Addresses
Primary practice location
106 10TH Ave NW
Red Bay, AL 35582-3800
Mailing address
332 County Road 1190
Tupelo, MS 38804-9639
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 |
|---|---|---|---|
| 4667 | AL | MD | Speech-Language Pathologist |
| S-4833 | MS | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626134400000",
"number": "1124690748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "332 COUNTY ROAD 1190",
"city": "TUPELO",
"state": "MS",
"postal_code": "388049639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 10TH AVE NW",
"city": "RED BAY",
"state": "AL",
"postal_code": "355823800",
"telephone_number": "844-653-0321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAULDIN",
"first_name": "KELLY",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-13",
"last_updated": "2021-07-13",
"certification_date": "2021-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AL",
"license": "4667",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MS",
"license": "S-4833",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Red Bay, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.