Individual provider Active NPI

Mallory Renee Mary Wilsher, M.S.

  • Speech-Language Pathologist
  • Oldsmar, FL
National Provider Identifier
1497200273
Registry record updated Aug 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SZ7730 Issued in FL
Practice address
219 Bay Arbor Blvd
Oldsmar, FL 34677-4667
Phone
(352) 339-3145
NPI assigned
Aug 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SZ7730 FL Primary

Addresses

Primary practice location

219 Bay Arbor Blvd
Oldsmar, FL 34677-4667

Mailing address

219 Bay Arbor Blvd
Oldsmar, FL 34677-4667
Phone (352) 339-3145

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SZ7730FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471824000000",
    "number": "1497200273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 BAY ARBOR BLVD",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346774667",
            "telephone_number": "352-339-3145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 BAY ARBOR BLVD",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346774667",
            "telephone_number": "352-339-3145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSHER",
        "first_name": "MALLORY",
        "middle_name": "RENEE MARY",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-22",
        "last_updated": "2016-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ7730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oldsmar, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2016; 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.