Individual provider Active NPI

Larry Elbert Bobbitt

  • Speech-Language Pathologist
  • Wake Forest, NC
National Provider Identifier
1104774082
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
30003887 Issued in NC
Practice address
3517 Coach Lantern Ave
Wake Forest, NC 27587-4866
Phone
(919) 948-8951
NPI assigned
Mar 18, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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 30003887 NC Primary

Addresses

Primary practice location

3517 Coach Lantern Ave
Wake Forest, NC 27587-4866

Mailing address

3517 Coach Lantern Ave
Wake Forest, NC 27587-4866
Phone (919) 948-8905

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
30003887NCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1773792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1104774082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3517 COACH LANTERN AVE",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275874866",
            "telephone_number": "919-948-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3517 COACH LANTERN AVE",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275874866",
            "telephone_number": "919-948-8951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBBITT",
        "first_name": "LARRY",
        "middle_name": "ELBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-03-18",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30003887",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 18, 2026; 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.