Individual provider Active NPI

Rebekah Woodard, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Wilmington, NC
National Provider Identifier
1083043087
Registry record updated Oct 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
10895 Issued in NC
Practice address
4130 Oleander Dr
Wilmington, NC 28403-6843
Phone
(910) 679-8385
Fax
(910) 679-8387
NPI assigned
Nov 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X NC
Speech-Language Pathologist 235Z00000X 10895 NC Primary

Addresses

Primary practice location

4130 Oleander Dr
Wilmington, NC 28403-6843

Mailing address

4130 Oleander Dr
Wilmington, NC 28403-6843
Phone (910) 679-8385

Other practice location 1

311 S McNeil St
Burgaw, NC 28425-5015
Phone (910) 679-8385

Other identifiers 1

IdentifierTypeStateIssuer
10895OtherNCSTATE SLP 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

LicenseStateTypeSpecialty
10895NCMDContractor

Practice roles

OrganizationSpecialtyStatusNew patients
Coastline Therapy Group, LLC Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 1

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": "1384128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1083043087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 OLEANDER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036843",
            "telephone_number": "910-679-8385",
            "fax_number": "910-679-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 OLEANDER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036843",
            "telephone_number": "910-679-8385",
            "fax_number": "910-679-8387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 S McNeil St",
            "address_purpose": "LOCATION",
            "city": "Burgaw",
            "state": "NC",
            "postal_code": "284255015",
            "country_code": "US",
            "telephone_number": "910-679-8385",
            "fax_number": "910-679-8387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODARD",
        "first_name": "REBEKAH",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-11",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "10895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE SLP LICENSE",
            "identifier": "10895",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; 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.