Active NPI
Madelyn Anna Bou
- Speech-Language Pathologist
- Bluffton, SC
National Provider Identifier
1760211429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 8898
- Practice address
- 254 Red Cedar St
Bluffton, SC 29910-8967 - Phone
- (843) 970-2899
- NPI assigned
- Jul 31, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 8898 | SC | Primary |
Addresses
Primary practice location
254 Red Cedar St
Bluffton, SC 29910-8967
Mailing address
78 Buck Island Road Apt. 106
Mailbox #50
Bluffton, SC 29910
Phone (404) 861-2113
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8898 | SC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722384000000",
"number": "1760211429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "78 BUCK ISLAND ROAD APT. 106",
"address_2": "MAILBOX #50",
"city": "BLUFFTON",
"state": "SC",
"postal_code": "29910",
"telephone_number": "404-861-2113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "254 RED CEDAR ST",
"city": "BLUFFTON",
"state": "SC",
"postal_code": "299108967",
"telephone_number": "843-970-2899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOU",
"first_name": "MADELYN",
"middle_name": "ANNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-31",
"last_updated": "2024-07-31",
"certification_date": "2024-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "SC",
"license": "8898",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 31, 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.