Mildred Zusselly McIlwain, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA11004 Issued in FL

Practice address

5972 Dahoon Dr
Pensacola, FL 32526-3246

Phone

(850) 696-7583

NPI assigned

Jan 18, 2010

Last updated

Nov 30, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Mildred Susie McIlwain Other name

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Gulf Coast Speech Language Services, PLLC

  • Speech-Language Pathologist
  • Pensacola, FL
  • NPI 1043820368

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1263772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1346571155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5972 DAHOON DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325263246",
            "telephone_number": "850-696-7583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5972 DAHOON DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325263246",
            "telephone_number": "850-696-7583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCILWAIN",
        "first_name": "MILDRED",
        "middle_name": "ZUSSELLY",
        "name_prefix": "Ms.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-18",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "FL",
            "license": "SA11004",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "SLP7100",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA11004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smcilwain@gulfcoastrehab.com",
            "affiliation": "N",
            "endpointDescription": "business email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5972 Dahoon Dr",
            "city": "Pensacola",
            "state": "FL",
            "country_code": "US",
            "postal_code": "325263246",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smcilwain@gulfcoastspeech.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5972 Dahoon Dr",
            "city": "Pensacola",
            "state": "FL",
            "country_code": "US",
            "postal_code": "325263246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MILDRED",
            "last_name": "MCILWAIN",
            "middle_name": "SUSIE",
            "credential": "M.S. CCC-SLP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Charles P McGrath, D.C.
• Margaret A McGrath, M.D.
• Shea D McGraw, CRNA
• Brooklyn McGue
• Dorotha McGuire
• Scott Austin McIntosh, M.D.
• Shelby Wagner McIntosh, DO
• Kayla McIntyre, PHARMD
• Tanya McIntyre, LMHC
• Laura Ann McKaskle, APRN

• Speech-Language Pathologist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.