NPIMap

Organization Active NPI

MP Speech Therapy

Doing business as Old Town Speech-Language Services

  • Speech-Language Pathologist
  • Bluffton, SC
National Provider Identifier
1629734124
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
MP SPEECH THERAPY
Doing business as
Old Town Speech-Language Services
Practice address
18 Scott Way
Bluffton, SC 29910-8714
Phone
(843) 259-2759
NPI assigned
Nov 10, 2021
Last updated
Jun 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Authorized official

Name
Madison Pruitt, M.A. CCC-SLPNPI 1518542257
Title
Speech-Language Pathologist
Phone
(302) 584-4740

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing and Speech Clinic/Center 261QH0700X NU
Speech-Language Pathologist 235Z00000X NU Primary

Addresses

Primary practice location

18 Scott Way
Bluffton, SC 29910-8714

Mailing address

52 9TH Ave
Bluffton, SC 29910-7670

Other practice location 1

52 9th Ave
Bluffton, SC 29910-7670
Phone (843) 259-2759

Other names 1

  • Old Town Speech-Language Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220927002321 SC Part B Supplier - Clinic/Group Practice 9335525443 Receives reassigned benefits from 4 practitioners
Practice locations: Bluffton, SC

National Provider Directory

National Provider Directory

Locations

1 Marianna Way
Unit 102
Bluffton, SC 29910
Phone (302) 584-4740

1195 May River Rd
Unit A
Bluffton, SC 29910
Phone (302) 584-4740

18 Scott Way
Bluffton, SC 29910
Phone (814) 937-3188

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1636502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686268800000",
    "number": "1629734124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 9TH AVE",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299107670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 SCOTT WAY",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299108714",
            "telephone_number": "843-259-2759"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "52 9th Ave",
            "address_purpose": "LOCATION",
            "city": "Bluffton",
            "state": "SC",
            "postal_code": "299107670",
            "country_code": "US",
            "telephone_number": "843-259-2759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MP SPEECH THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-10",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A",
        "authorized_official_last_name": "PRUITT",
        "authorized_official_first_name": "MADISON",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "302-584-4740",
        "authorized_official_credential": "M.A. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Old Town Speech-Language Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bluffton, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.