Angela Tova Fornville, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

9873 Issued in NC

Practice address

2408 Camille Dr
Winterville, NC 28590-9498

Phone

(252) 327-0930

NPI assigned

Oct 14, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Kinetic Phys Therapy and Wellness Inc

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  • NPI 1063733442
  Medicare reassignment NPD
• Venture Rehabilitation Group

  • Speech-Language Pathologist
  • Greenville, NC
  • NPI 1528135035
  NPD (past)

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

{
    "created_epoch": "1223942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1043462682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2408 CAMILLE DR",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285909498",
            "telephone_number": "252-327-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2408 CAMILLE DR",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285909498",
            "telephone_number": "252-327-0930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4105 Dudleys Grant Dr",
            "address_2": "Apt C",
            "address_purpose": "LOCATION",
            "city": "Winterville",
            "state": "NC",
            "postal_code": "285908207",
            "country_code": "US",
            "telephone_number": "252-227-4855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORNVILLE",
        "first_name": "ANGELA",
        "middle_name": "TOVA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-14",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "9873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annalisa Amato Ferguson
• Jeanne Finney, MS,RD,LDN,LPCA,NCC
• Linda Peer Fleming, M.A.
• Julia Floyd
• Brianna Nicole Fly, LCSW
• Gina Franklin, MSW,LCAS
• Freedom Focus and Wellness Counseling and Consultation PLLC
• Freedom Home Health Care
• Lauralee Selvina Fuhrmann
• Michael Emad Gadelkarim, PHARMD

• Speech-Language Pathologist in Winterville, NC
• Providers in Winterville, 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 Sep 5, 2019; 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.