Individual provider Active NPI

Mallory Blair Howard, M.ED. CCC-SLP

  • Speech-Language Pathologist
  • Dublin, GA
National Provider Identifier
1619710175
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
113 E Gaines St
Dublin, GA 31021-6157
Phone
(478) 595-0317
Fax
(888) 249-2172
NPI assigned
Jun 13, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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 Primary

Addresses

Primary practice location

113 E Gaines St
Dublin, GA 31021-6157

Mailing address

113 E Gaines St
Dublin, GA 31021-6157
Phone (478) 595-0317

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250709000668 GA Practitioner - Qualified Speech Language Pathologist 8729590039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Speech Pathology Services, LLCGroup PAC ID 5395097919, 3 clinicians

Practice addresses (Care Compare)

113 E Gaines St
Dublin, GA 31021-6157
Phone (478) 595-0317

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Speech Pathology Services, LLC Speech-Language Pathologist CurrentSince May 3, 2025 Accepting new patients

Locations

113 Gaines St
Dublin, GA 31021
Phone (478) 595-0031

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1718236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1619710175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 E GAINES ST",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310216157",
            "telephone_number": "478-595-0317",
            "fax_number": "888-249-2172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 E GAINES ST",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310216157",
            "telephone_number": "478-595-0317",
            "fax_number": "888-249-2172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWARD",
        "first_name": "MALLORY",
        "middle_name": "BLAIR",
        "credential": "M.ED. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-13",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.