Active NPI
Barry Whitehead, M.S., CCC-SLP
- Speech-Language Pathologist
- Wake Forest, NC
National Provider Identifier
1053518183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2238
- Practice address
- 121 Oakwood Dr
Wake Forest, NC 27587-9757 - Phone
- (410) 726-1116
- NPI assigned
- Jul 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2238 | NC | Primary |
| Speech-Language Pathologist | 235Z00000X | 656463 | MD |
Addresses
Primary practice location
121 Oakwood Dr
Wake Forest, NC 27587-9757
Mailing address
121 Oakwood Dr
Wake Forest, NC 27587-9757
Phone (410) 726-1116
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2238 | Other | NC | LICENSE |
| 656463 | Other | MD | LICENSE |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2238 | NC | MD | Mental Health Counselor |
| 656463 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053518183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 OAKWOOD DR",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275879757",
"telephone_number": "410-726-1116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 OAKWOOD DR",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275879757",
"telephone_number": "410-726-1116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITEHEAD",
"first_name": "BARRY",
"name_prefix": "Mr.",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "2238",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": "656463",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "2238",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "656463",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wake Forest, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.