Individual provider Active NPI

Marjorie V Mudri, MS SLP/CCC

  • Speech-Language Pathologist
  • Dunedin, FL
National Provider Identifier
1760627186
Registry record updated Dec 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 967 Issued in FL
Practice address
257 Seagate CT
Dunedin, FL 34698-4228
Phone
(727) 733-8172
Fax
(727) 733-8176
NPI assigned
Dec 15, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2008

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 SA 967 FL Primary

Addresses

Primary practice location

257 Seagate CT
Dunedin, FL 34698-4228

Mailing address

257 Seagate CT
Dunedin, FL 34698-4228
Phone (727) 733-8172

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SA 967FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1229299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229299200000",
    "number": "1760627186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 SEAGATE CT",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346984228",
            "telephone_number": "727-733-8172",
            "fax_number": "727-733-8176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 SEAGATE CT",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346984228",
            "telephone_number": "727-733-8172",
            "fax_number": "727-733-8176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDRI",
        "first_name": "MARJORIE",
        "middle_name": "V",
        "name_prefix": "Mrs.",
        "credential": "MS SLP/CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-15",
        "last_updated": "2008-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunedin, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2008; 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.