Active NPI
Marcia Dawson Mallamad, MA CCC SLP
- Specialist
- Cleveland, OH
National Provider Identifier
1255486890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- SP-6223
- Practice address
- 4553 Hinckley Industrial Pkwy
Cleveland, OH 44109-6009 - Phone
- (216) 635-3504
- Fax
- (216) 635-3530
- NPI assigned
- Jan 24, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | SP-6223 | OH | Primary |
Addresses
Primary practice location
4553 Hinckley Industrial Pkwy
Cleveland, OH 44109-6009
Mailing address
2963 Corydon Rd
Cleveland Heights, OH 44118-3530
Phone (216) 321-7884
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 340753561028 | Other | OH | CARESOURCE ID |
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)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP-6223 | OH | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Cuyahoga | 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.
-
- Public Health or Welfare Agency
- Parma, OH
- NPI 1164577904
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262563200000",
"number": "1255486890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2963 CORYDON RD",
"city": "CLEVELAND HEIGHTS",
"state": "OH",
"postal_code": "441183530",
"telephone_number": "216-321-7884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4553 HINCKLEY INDUSTRIAL PKWY",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441096009",
"telephone_number": "216-635-3504",
"fax_number": "216-635-3530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLAMAD",
"first_name": "MARCIA",
"middle_name": "DAWSON",
"credential": "MA CCC SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-24",
"last_updated": "2010-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OH",
"license": "SP-6223",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARESOURCE ID",
"identifier": "340753561028",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.