Michaela Dockery Torres, MA CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5623 Issued in NC

Practice address

3901 Wrightsville Ave
Wilmington, NC 28403-6255

Phone

(910) 679-8385

NPI assigned

Feb 2, 2006

Last updated

Aug 2, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ivyrehab North Carolina LLCGroup PAC ID 8820336324, 158 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ivyrehab North Carolina LLC

  • Physical Medicine & Rehabilitation Physician
  • Charlotte, NC
  • NPI 1629568647
  Medicare reassignment Care Compare group
• Coastal Speech and Reading Center

  • Speech-Language Pathologist
  • Lumberton, NC
  • NPI 1649626466
  NPD (past)
• Ivy North Carolina ABA, LLC

  • Behavior Analyst
  • Wilmington, NC
  • NPI 1629919675
  NPD (past)
• Ivyrehab North Carolina LLC

  • Physical Medicine & Rehabilitation Physician
  • Charlotte, NC
  • NPI 1528683935
  NPD (past)

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1083686109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 WRIGHTSVILLE AVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036255",
            "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": "3901 WRIGHTSVILLE AVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036255",
            "telephone_number": "910-679-8385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORRES",
        "first_name": "MICHAELA",
        "middle_name": "DOCKERY",
        "name_prefix": "Mrs.",
        "credential": "MA CCC SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "5623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11454870",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "9344871",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7411780",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "137XY",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "D6004",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sandra Susan Torres, M.D.
• Total Renal Care of North Carolina LLC (Southeastern Dialysis Center Wilmington)
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• Total Renal Care of North Carolina, LLC (New Hanover Dialysis)
• Justin Toth, PA-C

• Speech-Language Pathologist in Wilmington, NC
• Providers in Wilmington, 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 Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.