Active NPI
Elizabeth Verdell Walter, MED, CCC-SLP
- Speech-Language Pathologist
- Boiling Springs, SC
National Provider Identifier
1194740340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 3768
- Practice address
- 361 Shallowford Dr
Boiling Springs, SC 29316-5801 - Phone
- (864) 814-2649
- NPI assigned
- Jul 12, 2006
- 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 | 3768 | SC | Primary |
Addresses
Primary practice location
361 Shallowford Dr
Boiling Springs, SC 29316-5801
Mailing address
361 Shallowford Dr
Boiling Springs, SC 29316-5801
Phone (864) 814-2649
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SAO723 | Medicaid | SC |
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 Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3768 | SC | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1194740340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "361 SHALLOWFORD DR",
"city": "BOILING SPRINGS",
"state": "SC",
"postal_code": "293165801",
"telephone_number": "864-814-2649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "361 SHALLOWFORD DR",
"city": "BOILING SPRINGS",
"state": "SC",
"postal_code": "293165801",
"telephone_number": "864-814-2649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTER",
"first_name": "ELIZABETH",
"middle_name": "VERDELL",
"name_prefix": "Mrs.",
"credential": "MED, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-12",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "SC",
"license": "3768",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SAO723",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boiling Springs, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.