Individual provider Active NPI

Glinda Mauldin

  • Speech-Language Pathologist
  • Pinson, AL
National Provider Identifier
1447466370
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3045 Issued in AL
Practice address
6209 Windsor LN
Pinson, AL 35126-3490
Phone
(501) 697-1622
NPI assigned
May 15, 2007
Last updated
Feb 5, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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 SA8818 FL
Speech-Language Pathologist 235Z00000X 3045 AL Primary

Addresses

Primary practice location

6209 Windsor LN
Pinson, AL 35126-3490

Mailing address

6209 Windsor LN
Pinson, AL 35126-3490
Phone (501) 697-1622

Other practice location 1

611 S 13th St
Fort Pierce, FL 34950-4054
Phone (407) 748-4771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200415000933 AL Practitioner - Qualified Speech Language Pathologist 0446689590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

529 Beacon Pkwy W
Suite 101
Birmingham, AL 35209-3126
Phone (205) 444-2294

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3045ALMDInternal Medicine Physician
SA8818FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Anointed by Grace Designs, LLC Speech-Language Pathologist CurrentSince Feb 19, 2020 Accepting new patients

Locations

529 Beacon Pkwy W
Ste 101
Birmingham, AL 35209
Phone (205) 440-2294

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1447466370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6209 WINDSOR LN",
            "city": "PINSON",
            "state": "AL",
            "postal_code": "351263490",
            "telephone_number": "501-697-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6209 WINDSOR LN",
            "city": "PINSON",
            "state": "AL",
            "postal_code": "351263490",
            "telephone_number": "501-697-1622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "611 S 13th St",
            "address_purpose": "LOCATION",
            "city": "Fort Pierce",
            "state": "FL",
            "postal_code": "349504054",
            "country_code": "US",
            "telephone_number": "407-748-4771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAULDIN",
        "first_name": "GLINDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA8818",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AL",
            "license": "3045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinson, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.