Individual provider Active NPI

Sheri Lynn Mullen, SLP

  • Speech-Language Pathologist
  • Cape Coral, FL
National Provider Identifier
1588808968
Registry record updated Apr 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA4506 Issued in FL
Practice address
3046 Del Prado Blvd S Ste 2a
Cape Coral, FL 33904-7215
Phone
(239) 691-1555
Fax
(239) 549-5585
NPI assigned
Apr 29, 2009
Last updated
Apr 29, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2009

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 SA4506 FL Primary

Addresses

Primary practice location

3046 Del Prado Blvd S Ste 2a
Cape Coral, FL 33904-7215

Mailing address

PO Box 60051
Fort Myers, FL 33906-6051
Phone (239) 691-1555

Other identifiers 1

IdentifierTypeStateIssuer
1174747489OtherFLMEDICARE GROUP UPIN

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

State licenses

LicenseStateTypeSpecialty
SA4506FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240963200000",
    "number": "1588808968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60051",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339066051",
            "telephone_number": "239-691-1555",
            "fax_number": "239-549-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3046 DEL PRADO BLVD S STE 2A",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339047215",
            "telephone_number": "239-691-1555",
            "fax_number": "239-549-5585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "SHERI",
        "middle_name": "LYNN",
        "name_prefix": "Miss",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-29",
        "last_updated": "2009-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA4506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP UPIN",
            "identifier": "1174747489",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2009; 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.