Active NPI
Mary Lou Oreolt
- Speech-Language Pathologist
- Fort Walton Beach, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA 12164
- Practice address
- 2104 Lewis Turner Blvd
Complete Rehabilitation Services, Inc
Fort Walton Beach, FL 32547-1316 - Phone
- (850) 862-3728
- Fax
- (850) 862-6270
- NPI assigned
- Apr 5, 2013
- 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 | SA 12164 | FL | Primary |
Addresses
Primary practice location
2104 Lewis Turner Blvd
Complete Rehabilitation Services, Inc
Fort Walton Beach, FL 32547-1316
Mailing address
2104 Lewis Turner Blvd
Complete Rehabilitation Services, Inc
Fort Walton Beach, FL 32547-1316
Phone (850) 862-3728
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
| License | State | Type | Specialty |
|---|---|---|---|
| SA 12164 | FL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Speech Therapy Inc | Speech-Language Pathologist | Current | Accepting new patients |
| Complete Rehabilitation Services, Inc. | Speech-Language Pathologist | Past | Accepting new patients |
Locations
160 N NC 241 Hwy
Beulaville, NC 28518
Phone (888) 258-6905
124 E Park Dr
Beulaville, NC 28518
Phone (888) 258-6905
1506 Wayne Memorial Dr
Ste F
Goldsboro, NC 27534
Phone (888) 258-6905
Organizations & group practices 2
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.
-
- Speech-Language Pathologist
- Wilmington, NC
- NPI 1750782462
-
- Speech-Language Assistant
- Fort Walton Beach, FL
- NPI 1356446546
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365120000000",
"number": "1972846145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2104 LEWIS TURNER BLVD",
"address_2": "COMPLETE REHABILITATION SERVICES, INC",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325471316",
"telephone_number": "850-862-3728",
"fax_number": "850-862-6270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2104 LEWIS TURNER BLVD",
"address_2": "COMPLETE REHABILITATION SERVICES, INC",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325471316",
"telephone_number": "850-862-3728",
"fax_number": "850-862-6270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OREOLT",
"first_name": "MARY",
"middle_name": "LOU",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-04-05",
"last_updated": "2013-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA 12164",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Walton Beach, FL
- Okaloosa Academy Inc
- Okaloosa County Council on Aging
- Okaloosa County Council on Aging
- Okaloosa Walton Urology PA
- Onward Momentum Behavior Analysis and Mental Wellness Services, LLC
- Origin Psychiatry and Wellness LLC
- Kathleen Orosz
- Orthopaedic Associates, PA
- Phillip Z Ostrowski, PTA
- Marcos Otero, PA-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.