Individual provider Active NPI

Lori Ann Marullo, M.A.

  • Speech-Language Pathologist
  • Charlotte, NC
National Provider Identifier
1285893842
Registry record updated Jul 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5510 Issued in SC
Practice address
6911 Shannon Willow Rd Ste 700
Charlotte, NC 28226
Phone
(980) 540-3777
NPI assigned
Jun 8, 2008
Last updated
Jul 25, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 5510 SC Primary
Speech-Language Pathologist 235Z00000X 9025 NC

Addresses

Primary practice location

6911 Shannon Willow Rd Ste 700
Charlotte, NC 28226

Mailing address

13714 Cathedral Way
Charlotte, NC 28278-7300
Phone (716) 830-2267

Other practice location 1

41 Inwood Pl
Apt. 1
Buffalo, NY 14209-1022
Phone (716) 830-2267

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 Arts

State licenses

LicenseStateTypeSpecialty
9025NCMDProfessional Counselor
5510SCMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kidspeak Management, LLC 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1212883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1285893842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13714 CATHEDRAL WAY",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282787300",
            "telephone_number": "716-830-2267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6911 SHANNON WILLOW RD STE 700",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28226",
            "telephone_number": "980-540-3777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Inwood Pl",
            "address_2": "Apt. 1",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142091022",
            "country_code": "US",
            "telephone_number": "716-830-2267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARULLO",
        "first_name": "LORI",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-08",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "5510",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "9025",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.