Kristian Mark Wontroba

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

9009 Issued in NC

Practice address

910 Bremerton Dr
Greenville, NC 27858-6548

Phone

(252) 916-1029

Fax

(252) 355-9218

NPI assigned

Nov 14, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bright Start Therapy, Inc.

  • Speech-Language Pathologist
  • Lewiston, ME
  • NPI 1114363686
  NPD (past)

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1114204526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2417",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285902417",
            "telephone_number": "252-916-1029",
            "fax_number": "252-355-9218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 BREMERTON DR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278586548",
            "telephone_number": "252-916-1029",
            "fax_number": "252-355-9218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONTROBA",
        "first_name": "KRISTIAN",
        "middle_name": "MARK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-14",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "9009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly M. Womack, SLP
• Zachary Joseph Womack, ATC, LAT
• Kinsey Owens Womble, LCSW
• Women'S Health Center of Greenville
• Jan Howe Wong, M.D.
• John Woo, D.O.
• Amy Louise Wood, MD
• Jessica Alice Wood, MS, LMFT
• Judy W Wood, MD
• Kristy Nicole Wood, LCMHC

• Speech-Language Pathologist in Greenville, NC
• Providers in Greenville, 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 Nov 14, 2011; 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.