Active NPI
Wendy Yoshino Teal, CCC-SLP
- Speech-Language Pathologist
- Charlotte, NC
National Provider Identifier
1215913645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 5812
- Practice address
- 1805 Mt Isle Harbor Dr
Charlotte, NC 28214-5405 - Phone
- (704) 258-1724
- Fax
- (704) 598-3024
- NPI assigned
- Dec 18, 2005
- 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 | 5812 | NC | Primary |
Addresses
Primary practice location
1805 Mt Isle Harbor Dr
Charlotte, NC 28214-5405
Mailing address
PO Box 480462
Charlotte, NC 28269-5320
Phone (704) 258-1724
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7411893 | Medicaid | NC |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5812 | NC | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Theraplay Speech Services, Inc. | Speech-Language Pathologist | Current | Accepting new patients |
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.
-
- Early Intervention Provider Agency
- Charlotte, NC
- NPI 1942286372
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372723200000",
"number": "1215913645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 480462",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282695320",
"telephone_number": "704-258-1724",
"fax_number": "704-598-3024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1805 MT ISLE HARBOR DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282145405",
"telephone_number": "704-258-1724",
"fax_number": "704-598-3024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEAL",
"first_name": "WENDY",
"middle_name": "YOSHINO",
"name_prefix": "Mrs.",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-12-18",
"last_updated": "2013-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "5812",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7411893",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.