Individual provider Active NPI

Jordan Avery Price, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Fayetteville, NC
National Provider Identifier
1033919055
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
30003726 Issued in NC
Practice address
1289 Oliver St
Fayetteville, NC 28304-4450
Phone
(910) 483-8331
Fax
(910) 483-8335
NPI assigned
Mar 18, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 30003726 NC Primary

Addresses

Primary practice location

1289 Oliver St
Fayetteville, NC 28304-4450

Mailing address

PO Box 87294
Fayetteville, NC 28304-7294
Phone (910) 483-8331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250411000596 NC Practitioner - Qualified Speech Language Pathologist 7113441189 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Speech Therapy Inc Speech-Language Pathologist CurrentSince Mar 11, 2025 Accepting new patients
Pediatric Developmental Therapy Speech-Language Pathologist PastSince Dec 21, 2025 Accepting new patients
Pediatric Developmental Therapy PastSince Dec 21, 2025 Accepting new patients

Locations

124 E Park Dr
Beulaville, NC 28518
Phone (888) 258-6905

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1742256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1033919055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87294",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283047294",
            "telephone_number": "910-483-8331",
            "fax_number": "910-483-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1289 OLIVER ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044450",
            "telephone_number": "910-483-8331",
            "fax_number": "910-483-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICE",
        "first_name": "JORDAN",
        "middle_name": "AVERY",
        "name_prefix": "Mr.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-18",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30003726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.