Active NPI
Abigail Haenssler
- Speech-Language Pathologist
- Greenville, NC
National Provider Identifier
1043757693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 12968
- Practice address
- 600 Moye Blvd
Greenville, NC 27834 - Phone
- (252) 744-6104
- Fax
- (252) 744-6148
- NPI assigned
- Jan 20, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 12968 | NC | Primary |
Addresses
Primary practice location
600 Moye Blvd
Greenville, NC 27834
Mailing address
PO Box 751069
Charlotte, NC 28275-1069
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043757693 | Medicaid | NC | |
| 19XB2 | Other | NC | BCBS OF NC |
| Q609390322 | Other | NC | MEDICARE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12968 | NC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622592000000",
"number": "1043757693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 751069",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282751069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 MOYE BLVD",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "27834",
"telephone_number": "252-744-6104",
"fax_number": "252-744-6148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAENSSLER",
"first_name": "ABIGAIL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-20",
"last_updated": "2021-06-02",
"certification_date": "2021-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "12968",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1043757693",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF NC",
"identifier": "19XB2",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "Q609390322",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.