Active NPI
Mary Elizabeth Dunlap, SLP
- Speech-Language Pathologist
- Mount Pleasant, SC
National Provider Identifier
1497982474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4621
- Practice address
- 1127 Queensborough Blvd Ste 104
Mount Pleasant, SC 29464-5431 - Phone
- (843) 216-0290
- NPI assigned
- Jun 17, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 4621 | SC | Primary |
Addresses
Primary practice location
1127 Queensborough Blvd Ste 104
Mount Pleasant, SC 29464-5431
Mailing address
1127 Queensborough Blvd Ste 104
Mount Pleasant, SC 29464-5431
Phone (843) 216-0290
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12004296 | Other | CAQH | |
| SA1114 | Medicaid | SC |
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 |
|---|---|---|---|
| 4621 | SC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686096000000",
"number": "1497982474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1127 QUEENSBOROUGH BLVD STE 104",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294645431",
"telephone_number": "843-216-0290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1127 QUEENSBOROUGH BLVD STE 104",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294645431",
"telephone_number": "843-216-0290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNLAP",
"first_name": "MARY ELIZABETH",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-17",
"last_updated": "2023-06-07",
"certification_date": "2023-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "SC",
"license": "4621",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "12004296",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SA1114",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mount Pleasant, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.