Laren Ruth Evans – Speech-Language Pathologist

Key facts

NPI: 1134948383
Entity type: Individual (NPI type 1)
Primary specialty: Speech-Language Pathologist 235Z00000X
License: 30000868 (NC)
Practice address: 3796 Vest Mill Rd
Winston Salem, NC 27103-2912
Phone: (336) 837-4797
Fax: (336) 376-7711
NPI assigned: Oct 5, 2024
Sex: Female
Sole proprietor: No

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.

The Speech Lady, PLLC Speech-Language Pathologist · Pfafftown, NC · NPI 1487902144

NPD (past) SPEECH-LANGUAGE PATHOLOGIST

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
30000868	NC	MD	Speech-Language Pathologist

Practice roles

Organization	Specialty	Status	New patients
The Speech Lady, PLLC	Speech-Language Pathologist	Past since Oct 6, 2024	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Speech-Language Pathologist	235Z00000X	30000868	NC	Yes

Addresses

Primary practice location

3796 Vest Mill Rd
Winston Salem, NC 27103-2912

Mailing address

3637 Clinedale Rd
Pfafftown, NC 27040-9309
Phone (336) 837-4797

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 5, 2024.

{
    "created_epoch": "1728086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728086400000",
    "number": "1134948383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3637 CLINEDALE RD",
            "city": "PFAFFTOWN",
            "state": "NC",
            "postal_code": "270409309",
            "telephone_number": "336-837-4797",
            "fax_number": "336-376-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3796 VEST MILL RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032912",
            "telephone_number": "336-837-4797",
            "fax_number": "336-376-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "LAREN",
        "middle_name": "RUTH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-05",
        "last_updated": "2024-10-05",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30000868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

All providers in Winston Salem, NC · Speech-Language Pathologist in North Carolina

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.