Jennifer L Rosenthal-Dibb, MS CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3200 Issued in NC

Practice address

4602 Cumberland Rd
Fayetteville, NC 28306-2412

Phone

(910) 423-5622

Fax

(910) 423-5538

NPI assigned

Nov 9, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Therapy Playground, Inc

  • Speech-Language Pathologist
  • Fayetteville, NC
  • NPI 1164974937
  NPD Authorized official
• Therapy Playground, Inc

  • Speech-Language Pathologist
  • Fayetteville, NC
  • NPI 1467433680
  NPD (past) Authorized official
• Therapy Playground, Inc

  • Physical Therapy Clinic/Center
  • Spring Lake, NC
  • NPI 1528552007
  NPD (past) Authorized official
• Discovery Playground, Inc

  • Developmental Therapist
  • Fayetteville, NC
  • NPI 1447500285
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1225019094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4602 CUMBERLAND RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283062412",
            "telephone_number": "910-423-5622",
            "fax_number": "910-378-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4602 CUMBERLAND RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283062412",
            "telephone_number": "910-423-5622",
            "fax_number": "910-423-5538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENTHAL-DIBB",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-09",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "3200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7464046",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "1156E",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Rose, M.A
• Laura Gay Rose, RN
• Samisha Tankeyia Rose
• Shannon Rose
• Carl Willis Rosenberg, LMFT
• Amanda K Ross, LCSWA
• Charles J Ross, IDMT
• Jerlinda Gladys Camille Ross, M.D.
• Karen Ross
• Karlishia Shenay Ross

• Speech-Language Pathologist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.