Individual provider Active NPI

Mallie Philipps

  • Speech-Language Pathologist
  • Aurora, CO
National Provider Identifier
1164101234
Registry record updated Aug 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
15701 E 1St Ave
Aurora, CO 80011-9060
Phone
(303) 344-8060
NPI assigned
Jul 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2026

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 Primary

Addresses

Primary practice location

15701 E 1St Ave
Aurora, CO 80011-9060

Mailing address

15701 E 1St Ave
Aurora, CO 80011-9060
Phone (303) 344-8060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240802000881 FL Practitioner - Qualified Speech Language Pathologist 3577000934 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kernaghan and Moore: Speech and Language Therapy Services, Inc. Speech-Language Pathologist CurrentSince Jul 23, 2024 Accepting new patients
Theraplay, LLC Speech-Language Pathologist PastSince Jul 16, 2023 Accepting new patients
Kernaghan and Moore: Speech and Language Therapy Services, Inc. Speech-Language Pathologist Past Accepting new patients
Theraplay, LLC PastSince Jul 16, 2023 Accepting new patients

Locations

6245 State Road 54
New Prt Rchy, FL 34653
Phone (727) 376-1111

1226 Mariner Blvd
Spring Hill, FL 34609
Phone (352) 666-5550

Organizations & group practices 4

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": "1689292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1164101234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15701 E 1ST AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800119060",
            "telephone_number": "303-344-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15701 E 1ST AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800119060",
            "telephone_number": "303-344-8060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILIPPS",
        "first_name": "MALLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-14",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2026; 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.

Verify at the official NPI Registry.