Individual provider Active NPI

Jodi Maloy Williams, M.ED CCC/SLP

  • Speech-Language Pathologist
  • Douglas, GA
National Provider Identifier
1649586462
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP007580 Issued in GA
Practice address
151 Pleasant LN
Douglas, GA 31533-8028
Phone
(912) 590-2516
Fax
(912) 214-5206
NPI assigned
Aug 31, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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 SLP007580 GA Primary

Addresses

Primary practice location

151 Pleasant LN
Douglas, GA 31533-8028

Mailing address

151 Pleasant LN
Douglas, GA 31533-8028
Phone (912) 590-2516

Other names 1

  • Jodi Maloy Former name

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
SLP007580GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Speech Solutions LLC CurrentSince Oct 19, 2020 Accepting new patients

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": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1649586462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 PLEASANT LN",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315338028",
            "telephone_number": "912-590-2516",
            "fax_number": "912-214-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 PLEASANT LN",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315338028",
            "telephone_number": "912-590-2516",
            "fax_number": "912-214-5206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JODI",
        "middle_name": "MALOY",
        "credential": "M.ED CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-31",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP007580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JODI",
            "last_name": "MALOY",
            "credential": "M ED CCC/SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Douglas, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; 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.