Mary F Blisard, M.A., CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

YS001611 Issued in NJ

Practice address

111 S Bartram Ave
Atlantic City, NJ 08401-5707

Phone

(609) 289-2625

NPI assigned

Oct 1, 2010

Last updated

Oct 1, 2010By the provider in NPPES

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)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1285891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285891200000",
    "number": "1841509361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S BARTRAM AVE",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084015707",
            "telephone_number": "609-289-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S BARTRAM AVE",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084015707",
            "telephone_number": "609-289-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLISARD",
        "first_name": "MARY",
        "middle_name": "F",
        "credential": "M.A., CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-01",
        "last_updated": "2010-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "YS001611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Atlantic City, NJ
• Providers in Atlantic City, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2010; 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.