Mallary McLemore Mardis, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

S3445 Issued in MS

Practice address

123 Jefferson Davis Blvd
Natchez, MS 39120-5103

Phone

(601) 445-0005

Fax

(601) 445-0370

NPI assigned

Sep 29, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Key Medical Supply,LLC

  • Durable Medical Equipment & Medical Supplies
  • Natchez, MS
  • NPI 1598145807
  NPD (past)
• Key Rehab Associates, Inc.

  • Physical Therapist
  • Natchez, MS
  • NPI 1104985399

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1659680262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 JEFFERSON DAVIS BLVD",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391205103",
            "telephone_number": "601-445-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 JEFFERSON DAVIS BLVD",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391205103",
            "telephone_number": "601-445-0005",
            "fax_number": "601-445-0370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARDIS",
        "first_name": "MALLARY",
        "middle_name": "MCLEMORE",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-29",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S3445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magnolia House L.P.
• Magnolia Medical, LLC
• Magnolia Medical, LLC
• Raymond K Mahar, NP
• Joseph-Charles Mardini, D.D.S.
• Elizabeth R. Marks, DPT
• Eunice Monique Marsaw Evans
• Christopher Lee Martin, MD
• Lauren A Massey, MCD, CCC-SLP
• Urban Edwin Mathieu, MD

• Speech-Language Pathologist in Natchez, MS
• Providers in Natchez, MS by specialty
• Speech-Language Pathologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.