Active NPI
Stacy Tyner Duvall, MS, CCC-SLP
- Speech-Language Pathologist
- Goldsboro, NC
National Provider Identifier
1215061288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7713
- Practice address
- 2401 Wayne Memorial Dr
Goldsboro, NC 27534-1727 - Phone
- (919) 736-2121
- NPI assigned
- Mar 14, 2007
- Last updated
- Jun 7, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 3998 | SC | |
| Speech-Language Pathologist | 235Z00000X | 7713 | NC | Primary |
Addresses
Primary practice location
2401 Wayne Memorial Dr
Goldsboro, NC 27534-1727
Mailing address
100 Madalyn CT
Dudley, NC 28333-5001
Phone (984) 277-9804
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7713 | NC | MD | Mental Health Counselor |
| 3998 | SC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654560000000",
"number": "1215061288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MADALYN CT",
"city": "DUDLEY",
"state": "NC",
"postal_code": "283335001",
"telephone_number": "984-277-9804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 WAYNE MEMORIAL DR",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275341727",
"telephone_number": "919-736-2121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUVALL",
"first_name": "STACY",
"middle_name": "TYNER",
"name_prefix": "Miss",
"credential": "MS, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-14",
"last_updated": "2022-06-07",
"certification_date": "2022-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "SC",
"license": "3998",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "7713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goldsboro, NC
- Muin Mousa Dugom, M.D., FACP
- Betty Lewis Dukay, MSW, LCSW
- Sherry Letchworth Dunmire, MS,CCC-SLP
- Cher Alexis Durham, CNM, WHNP-BC
- Heather L Durham, PHARM.D.
- Dva Healthcare Renal Care Inc (Coastal Plains)
- Dva Renal Healthcare Inc (Goldsboro Dialysis)
- Dva Renal Healthcare Inc (Goldsboro South Dialysis)
- Dwi and Counseling Services, Inc.
- Dwi and Counseling Services, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.