NPIMap

Organization Active NPI

My Blue Sky, PC

  • Speech-Language Pathologist
  • Fayetteville, NC
National Provider Identifier
1124323381
Registry record updated Jun 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
MY BLUE SKY, PC
Practice address
3419B Melrose Rd
Fayetteville, NC 28304-1608
Phone
(910) 257-2005
Fax
(910) 485-6315
NPI assigned
Jan 20, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2016

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

Authorized official

Name
Ms. Meredith L Broughton, MA, CCC-SLPNPI 1144347733
Title
Owner/ Lead Pathologist
Phone
(910) 257-2005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

3419B Melrose Rd
Fayetteville, NC 28304-1608

Mailing address

3419B Melrose Rd
Fayetteville, NC 28304-1608
Phone (910) 257-2005

Other names 1

  • SANDHILLS THERAPY SOLUTIONS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
My Blue Sky PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1762 Metromedical Dr
Fayetteville, NC 28304
Phone (910) 436-0424

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1295481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467244800000",
    "number": "1124323381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3419B MELROSE RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283041608",
            "telephone_number": "910-257-2005",
            "fax_number": "910-485-6315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419B MELROSE RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283041608",
            "telephone_number": "910-257-2005",
            "fax_number": "910-485-6315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY BLUE SKY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-20",
        "last_updated": "2016-06-30",
        "status": "A",
        "authorized_official_last_name": "BROUGHTON",
        "authorized_official_first_name": "MEREDITH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/ LEAD PATHOLOGIST",
        "authorized_official_telephone_number": "910-257-2005",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SANDHILLS THERAPY SOLUTIONS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; 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.