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Mallory Lynn Tillis , SLP

Speech-Language Pathologist β€’ Jacksonville, FL

Active NPI 1124519145 Individual Practitioner Female Practitioner
Practice location in NPPES

6820 Southpoint Pkwy Ste 9
Jacksonville, FL 322166277

Call 0398888754 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

6820 Southpoint Pkwy Ste 9

Jacksonville, FL 322166277

Telephone 0398888754
Organization at the Same NPPES Address or Phone
Vocational Development Group, Llc Facility NPI 1568135523

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2018

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Jacksonville and Florida

558 active clinicians are listed under Speech-Language Pathologist with a practice address in Jacksonville, FL (11,513 in Florida).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Jacksonville

1.6% of these 558 clinicians have the CMS telehealth indicator.

4.8% of these 558 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-07-28
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

License # reported to NPPES CO SLP.0005885

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.

Speech-Language Pathologist

NUCC Taxonomy Code: 235Z00000X

License # reported to NPPES FL SA14700

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Florida Department of Health Medical Quality Assurance.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Business Mailing Address July 28, 2024

Registered at 15701 E 1ST AVE STE 106, AURORA, CO 800119037

πŸ‘€
Provider Name / Credentials Updated July 28, 2024

Recorded as MALLORY TILLIS, SLP

πŸ“
Updated Practice Location December 08, 2021

Registered at 6820 SOUTHPOINT PKWY STE 9, JACKSONVILLE, FL 322166277 (Tel: 0398888754)

βœ…
NPI Profile Active May 24, 2018

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) May 24, 2018

Registered at 6867 SOUTHPOINT DR N, JACKSONVILLE, FL 322168043 (Tel: 9046196071)

πŸ“
Business Mailing Address (Initial Record) May 24, 2018

Registered at 6867 SOUTHPOINT DR N, JACKSONVILLE, FL 322168043 (Tel: 9046196071)

πŸ‘€
Provider Name / Credentials (Initial Record) May 24, 2018

Recorded as MALLORY BUTLER, SLP

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 24, 2018

Speech-Language Pathologist (license number reported to NPPES: FL SA14700)

🟒
Initial NPI Registration & Enumeration May 24, 2018

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1124519145
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 24, 2018
Last Update: July 28, 2024
Sole Proprietor: No

Other Speech-Language Pathologists in Jacksonville

All Speech-Language Pathologists in Jacksonville

Mailing Address

15701 E 1st Ave Ste 106

Aurora, CO 800119037

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.