Active NPI
Serena Rene Rector, M.A., CCC-SLP
- Speech-Language Pathologist
- Lillington, NC
National Provider Identifier
1124251855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 8636
- Practice address
- 317 Braddock Dr
Dumc Box 3887
Lillington, NC 27546-6311 - Phone
- (910) 703-9169
- NPI assigned
- Aug 28, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 8636 | NC | Primary |
Addresses
Primary practice location
317 Braddock Dr
Dumc Box 3887
Lillington, NC 27546-6311
Mailing address
317 Braddock Dr
Lillington, NC 27546-6311
Phone (910) 703-9169
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12156608 | Other | NC | AMERICAN SPEECH-LANGUAGE HEARING ASSOCIATION CERTIFICATION-CCC |
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8636 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359331200000",
"number": "1124251855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "317 BRADDOCK DR",
"city": "LILLINGTON",
"state": "NC",
"postal_code": "275466311",
"telephone_number": "910-703-9169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "317 BRADDOCK DR",
"address_2": "DUMC BOX 3887",
"city": "LILLINGTON",
"state": "NC",
"postal_code": "275466311",
"telephone_number": "910-703-9169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RECTOR",
"first_name": "SERENA",
"middle_name": "RENE",
"credential": "M.A., CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-28",
"last_updated": "2013-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "8636",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN SPEECH-LANGUAGE HEARING ASSOCIATION CERTIFICATION-CCC",
"identifier": "12156608",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lillington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.