Individual provider Active NPI

Danelle H Betancourt, MS. CCC-SLP

  • Speech-Language Pathologist
  • Henderson, NC
National Provider Identifier
1043470784
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4417 Issued in NC
Practice address
2275 Ruin Creek Rd
Henderson, NC 27537-8732
Phone
(252) 438-1777
NPI assigned
Jun 16, 2008
Last updated
Jun 16, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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 4417 NC Primary

Addresses

Primary practice location

2275 Ruin Creek Rd
Henderson, NC 27537-8732

Mailing address

6100 Tiffield Way
Wake Forest, NC 27587-4299
Phone (919) 453-2615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4417NCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213574400000",
    "number": "1043470784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 TIFFIELD WAY",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275874299",
            "telephone_number": "919-453-2615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 RUIN CREEK RD",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275378732",
            "telephone_number": "252-438-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETANCOURT",
        "first_name": "DANELLE",
        "middle_name": "H",
        "credential": "MS. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2008-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "4417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.