Full Bloom Speech Language Pathology

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

FULL BLOOM SPEECH LANGUAGE PATHOLOGY

Practice address

17111 Kenton Dr Ste 206B
Cornelius, NC 28031-5650

Phone

(937) 369-6613

NPI assigned

May 21, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Amy Lynn Elder, MA, SLPNPI 1780876235

Title

Speech Language Pathologist

Phone

(937) 369-6613

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amy Lynn Elder, CCC-SLP

  • Speech-Language Pathologist
  • Charlotte, NC
  • NPI 1780876235
  NPD Authorized official

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

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716249600000",
    "number": "1225877293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17031 HUGH TORANCE PKWY",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280781276",
            "telephone_number": "937-369-6613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17111 KENTON DR STE 206B",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280315650",
            "telephone_number": "937-369-6613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL BLOOM SPEECH LANGUAGE PATHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "ELDER",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "937-369-6613",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA, SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Franco, NBC-HWC
• Leslie Renee Francois, LCSW
• Cari Marie Fresoli, OTRL
• Friedman Eye Care OD PLLC
• Steven David Friedman, OD
• Apiffany Alexandria Gaither, M.S.
• Reilly Gallagher
• Natalie Ann Gallant, MS
• Avery Pope Gallo, PA-C
• Jennifer Garcia, LPCA

• Speech-Language Pathologist in Cornelius, NC
• Providers in Cornelius, 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 May 21, 2024; 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.