Individual provider Active NPI

Jessie Sue Smith Mewshaw, MS, CCC-SLP

  • Speech-Language Pathologist
  • Durham, NC
National Provider Identifier
1144620097
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
15051810 Issued in NC
Practice address
1009 Bradburn Dr
Durham, NC 27713-6904
Phone
(919) 228-8094
Fax
(984) 287-7200
NPI assigned
Aug 28, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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 15051810 NC Primary

Addresses

Primary practice location

1009 Bradburn Dr
Durham, NC 27713-6904

Mailing address

1009 Bradburn Dr
Durham, NC 27713-6904
Phone (919) 228-8094

Other practice location 1

PO Box 5183
Cary, NC 27512-5183
Phone (919) 355-8194

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
15051810NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Radiant Moments Pediatric Therapy, PLLC Speech-Language Pathologist CurrentSince Jul 13, 2025 Accepting new patients
Emerge-a Child'S Place, PLLC Speech-Language Pathologist PastSince Sep 1, 2022 Accepting new patients

Organizations & group practices 2

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": "1409184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1144620097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 BRADBURN DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136904",
            "telephone_number": "919-228-8094",
            "fax_number": "984-287-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 BRADBURN DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136904",
            "telephone_number": "919-228-8094",
            "fax_number": "984-287-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "PO Box 5183",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275125183",
            "country_code": "US",
            "telephone_number": "919-355-8194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEWSHAW",
        "first_name": "JESSIE",
        "middle_name": "SUE SMITH",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-28",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "15051810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2025; 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.