Individual provider Active NPI

Stephanie Gerlich Tolley, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Charlotte, NC
National Provider Identifier
1114282480
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
9899 Issued in NC
Practice address
905 E. 36TH St. Charlotte, NC 28205
Charlotte, NC 28205-2820
Phone
(251) 689-1662
Fax
(833) 814-5516
NPI assigned
Jul 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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 9899 NC Primary

Addresses

Primary practice location

905 E. 36TH St. Charlotte, NC 28205
Charlotte, NC 28205-2820

Mailing address

905 E 36TH St
Charlotte, NC 28205-1650
Phone (251) 689-1662

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
9899NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Stephanie Tolley Speech Therapist PLLC Speech-Language Pathologist CurrentSince Feb 7, 2021 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": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1114282480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 E 36TH ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282051650",
            "telephone_number": "251-689-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 E. 36TH ST. CHARLOTTE, NC 28205",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282052820",
            "telephone_number": "251-689-1662",
            "fax_number": "833-814-5516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLLEY",
        "first_name": "STEPHANIE",
        "middle_name": "GERLICH",
        "name_prefix": "Ms.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "9899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.