Lara Kelly Perretta

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3673 Issued in NC

Practice address

2744 S 17TH St
Wilmington, NC 28412-6606

Phone

(910) 452-1114

NPI assigned

Jan 30, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fox Rehab SLP NC PLLC

  • Speech-Language Pathologist
  • Matthews, NC
  • NPI 1578341632
  NPD

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1003522459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2744 S 17TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126606",
            "telephone_number": "910-452-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2744 S 17TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284126606",
            "telephone_number": "910-452-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRETTA",
        "first_name": "LARA",
        "middle_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-30",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "IA",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "3673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehab SLP NC PLLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2008 Moore Rd",
            "city": "Matthews",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281054978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Deborah Perez-Lopez, MS
• Perihan S. Warren, FNP-C , LLC.
• Brian K Perkins
• Jenny Lee Trest Perkins, FNP-BC
• Allison Mackenzie Perrault, LCSW-A
• Perry J. Castellano, O.D., P.a.
• Brittney Perry
• Doreen Perry, CCC-SLP
• Jennifer Nicole Perry
• Madison Claire Perry, PA-C

• Speech-Language Pathologist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.