Michael Ann Tally

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

S3683 Issued in MS

Practice address

3077 Highway 371 N
Mantachie, MS 38855-7274

Phone

(662) 282-4949

Fax

(662) 282-4955

NPI assigned

Dec 29, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Drayer Physical Therapy Institute LLC

  • Physical Therapist
  • Columbus, MS
  • NPI 1073859807
  NPD (past)
• Drayer Physical Therapy Mississippi LLC

  • Physical Therapist
  • Crystal Springs, MS
  • NPI 1801333521
  NPD (past)

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

{
    "created_epoch": "1451347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451347200000",
    "number": "1417312950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3077 HIGHWAY 371 N",
            "city": "MANTACHIE",
            "state": "MS",
            "postal_code": "388557274",
            "telephone_number": "662-282-4949",
            "fax_number": "662-282-4955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3077 HIGHWAY 371 N",
            "city": "MANTACHIE",
            "state": "MS",
            "postal_code": "388557274",
            "telephone_number": "662-282-4949",
            "fax_number": "662-282-4955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLY",
        "first_name": "MICHAEL",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-29",
        "last_updated": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S3683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristi Diann Smith, MSN, FNP-C
• Katlyn Spradling
• Virginia M Sprayberry, SLP
• Kimberly M Stanley, FNP
• Leita N Stark, FNP-BC
• Trinity'S Pharmacy
• Wal-Mart Stores East LP
• Paige Westmoreland, PMHNP
• Mallory Williams

• Speech-Language Pathologist in Mantachie, MS
• Providers in Mantachie, MS by specialty
• Speech-Language Pathologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; 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.