Active NPI
Julia Elaine Mallard, SLP
- Speech-Language Pathologist
- Clayton, NC
National Provider Identifier
1295809325
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 5663
- Practice address
- 200 Waterford Dr
Clayton, NC 27520-7951 - Phone
- (919) 264-2233
- NPI assigned
- Nov 20, 2006
- Last updated
- Jul 8, 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 5663 | NC | Primary |
Addresses
Primary practice location
200 Waterford Dr
Clayton, NC 27520-7951
Mailing address
200 Waterford Dr
Clayton, NC 27520-7951
Phone (919) 264-2233
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5663 | NC | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295809325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 WATERFORD DR",
"city": "CLAYTON",
"state": "NC",
"postal_code": "275207951",
"telephone_number": "919-264-2233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 WATERFORD DR",
"city": "CLAYTON",
"state": "NC",
"postal_code": "275207951",
"telephone_number": "919-264-2233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLARD",
"first_name": "JULIA",
"middle_name": "ELAINE",
"name_prefix": "Mrs.",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "5663",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clayton, NC
- Mainstreet and Kidsstreet of North Carolina PLLC (MainStreet Family Care)
- Carley Malak
- Malek & Knight, DDS, PA V (Axiom Dentistry of Clayton)
- Nicole M Malfi, NP
- Nisha Mall
- Moira Grace Malley Johnson, DPT
- Loretta M Maloy, LMBT
- Michelle Rose Mangus
- Fernanda Raquel Marchan Hernandez, SA-C
- Steven Angelos Marinos, NURSE PRACTITIONER
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.