Active NPI
Lydia Malloy, AU.D., CCC-SLP
- Audiologist
- Fort Rucker, AL
National Provider Identifier
1396038352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 3564
- Practice address
- 301 Andrews Ave
Fort Rucker, AL 36362-0001 - Phone
- (334) 255-7838
- NPI assigned
- May 25, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 4346 | SC | |
| Audiologist | 231H00000X | 3564 | AL | Primary |
Addresses
Primary practice location
301 Andrews Ave
Fort Rucker, AL 36362-0001
Mailing address
301 Andrews Ave
Fort Rucker, AL 36362-0001
Phone (334) 255-7838
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 |
|---|---|---|---|
| 4346 | SC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389225600000",
"number": "1396038352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 ANDREWS AVE",
"city": "FORT RUCKER",
"state": "AL",
"postal_code": "363620001",
"telephone_number": "334-255-7838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 ANDREWS AVE",
"city": "FORT RUCKER",
"state": "AL",
"postal_code": "363620001",
"telephone_number": "334-255-7838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLOY",
"first_name": "LYDIA",
"name_prefix": "Dr.",
"credential": "AU.D., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-25",
"last_updated": "2014-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "SC",
"license": "4346",
"primary": false
},
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "AL",
"license": "3564",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Rucker, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.