MARY ANN WALLER (NPI# 1689188906) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689188906 |
| Entity Type | Individual |
| Full Name | MARY ANN WALLER |
| Credential | SLP |
| Practice Address |
3131 S Main St Moultrie GA 31768-6925 |
| Mailing Address |
Po Box 40 Moultrie GA 31776-0040 |
| Practice Telephone | 2298903553 |
| Practice Fax Number | 2298903557 |
| Mailing Telephone | 2298903553 |
| Mailing Fax Number | 2298903557 |
| Enumeration Date | 2017-11-22 |
| Last Update Date | 2017-11-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | SLP009908 | GA | Speech, Language and Hearing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679772669 | Mary M. Waller | Dentist | 501 Freeman St., Genoa City, WI 53128-0159 | 2007-07-11 |
| 1770932840 | Mary Waller | Counselor | 10985 N Harrells Ferry Rd, 2nd Floor, Baton Rouge, LA 70816-8362 | 2016-06-08 |
| 1649523457 | Mary Ericson Waller | Occupational Therapist | 2720 Sunset Blvd, West Columbia, SC 29169-4810 | 2012-10-17 |
| 1104188705 | Mary Waller | Registered Nurse | 223 N Anderson Dr, Swainsboro, GA 30401-4440 | 2012-06-11 |
| 1154402113 | Mary Elizabeth Waller | Psychologist | 3619 Park East Dr, Suite 313, Beachwood, OH 44122-4330 | 2006-10-18 |
| 1821016999 | Mary Wisocki Waller | Speech-Language Pathologist | 530 E 2nd St, Duluth, MN 55805-1913 | 2006-07-17 |
| 1356329973 | Mary B Waller | Nurse Anesthetist, Certified Registered | 1000 W Moreno St, Pensacola, FL 32501-2316 | 2006-01-04 |
| 1225024615 | Mary Melanie Waller | Urology | 1200 N East St, Olney, IL 62450-2432 | 2005-09-21 |
| Street Address |
3131 S MAIN ST |
| City | MOULTRIE |
| State | GA |
| Zip Code | 31768-6925 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255323564 | Dale Mcgregor | Emergency Medicine | 3131 S Main St, Moultrie, GA 31768-6925 | 2005-08-22 |
| 1144861485 | Rebecca Lee Hayes | Nurse Practitioner | 3131 S Main St, Moultrie, GA 31768-6925 | 2019-10-07 |
| 1942865480 | Colquitt Regional Pathology, LLC | Pathology | 3131 S Main St, Moultrie, GA 31768-6925 | 2019-05-09 |
| 1669937264 | Colquitt County Hospital Authority | Pharmacy | 3131 S Main St, Moultrie, GA 31768-6925 | 2019-02-07 |
| 1407331143 | Christopher Neil Medders | Nurse Practitioner | 3131 S Main St, Moultrie, GA 31768-6925 | 2018-09-28 |
| 1255832671 | Alexa Smith | Occupational Therapist | 3131 S Main St, Moultrie, GA 31768-6925 | 2018-02-21 |
| 1346757481 | Jeffery W Roberts | Nurse Anesthetist, Certified Registered | 3131 S Main St, Moultrie, GA 31768-6925 | 2018-01-10 |
| 1720593239 | Colquitt Regional Medical Center | Ambulance | 3131 S Main St, Moultrie, GA 31768-6925 | 2017-12-06 |
| 1063923688 | Radiology Associates of Moultrie LLC | Radiology | 3131 S Main St, Moultrie, GA 31768-6925 | 2017-10-23 |
| 1629590898 | Amanda Jackson | Nurse Anesthetist, Certified Registered | 3131 S Main St, Moultrie, GA 31768-6925 | 2017-07-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356975452 | Zachary Schiffer | Specialist/Technologist | 3131 S Main Street, Moultrie, GA 31768 | 2020-02-27 |
| 1326697731 | Daisy Concierge Care | Nursing Care | 437 S. Morris Rd Lt 1, Moultrie, GA 31768 | 2019-09-09 |
| 1194208751 | Regina Mercer Ward | Nurse Practitioner | 1724 Villa Dr Sw, Moultrie, GA 31768 | 2018-09-10 |
| 1225473630 | Moultrie Orthodontics, P.C. | Clinic/Center | 12 Longleaf Office Park, Moultrie, GA 31768 | 2013-04-30 |
| 1497032239 | Freds Stores of Tennessee Inc | Pharmacy | 2601 South Main Street, Moultrie, GA 31768 | 2011-11-08 |
| 1821382672 | Colquitt Regional Ob/gyn, LLC | Obstetrics & Gynecology | 3 Sweet Bay Ct, Moultrie, GA 31768 | 2011-06-08 |
| 1568779809 | Shana Goodno | Nurse Practitioner | 207 31 St Ave Se, Moultrie, GA 31768 | 2010-09-08 |
| 1508177445 | Cherokee Rose Emergency Physicians | Emergency Medicine | 3131 South Main Street, Moultrie, GA 31768 | 2010-06-25 |
| 1023299963 | Hetal Patel | Counselor | 600 2nd St South East, Moultrie, GA 31768 | 2007-11-20 |
| 1720146756 | William C Byrd Inc | Assisted Living Facility | 498 5th Street Se, Moultrie, GA 31768 | 2006-12-04 |
| Find all providers in zip 31768 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821453291 | Sherryl Stewart | Speech-Language Pathologist | 302 Holly Trl, Moultrie, GA 31768-6825 | 2015-12-29 |
| 1083874895 | Opal Jean M Norman | Speech-Language Pathologist | 4969 Old Adel Rd, Moultrie, GA 31788-1276 | 2008-06-16 |
| 1407818008 | Melody U Baker | Speech-Language Pathologist | 300 Sunset Circle, Moultrie, GA 31768 | 2006-04-06 |
| 1740722321 | Ivy Jarvis | Speech-Language Pathologist | 3131 S Main St, Moultrie, GA 31768-6925 | 2016-11-14 |
| 1144602186 | Wendy Pate | Speech-Language Pathologist | 3131 S Main St, Moultrie, GA 31768-6925 | 2015-06-26 |
| 1659784668 | Linsey M Cone | Speech-Language Pathologist | 300 Sunset Cir, Moultrie, GA 31768-6934 | 2014-06-06 |
| 1154760296 | Debra J Peacock | Speech-Language Pathologist | 300 Sunset Cir, Moultrie, GA 31768-6934 | 2013-06-21 |
| 1184999641 | Whitney E. Smith | Speech-Language Pathologist | 3131 S Main St, Moultrie, GA 31768-6925 | 2012-03-16 |
| 1013154608 | Heather A Huddleston | Speech-Language Pathologist | 300 Sunset Cir, Moultrie, GA 31768-6934 | 2009-01-19 |
| 1356519995 | Whitney Alison Williams | Speech-Language Pathologist | 300 Sunset Cir, Moultrie, GA 31768-6934 | 2008-02-18 |
| Find all providers in MOULTRIE | ||||
Please comment or provide details below to improve the information on MARY ANN WALLER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.