Individual provider Active NPI

Mae Keogh

  • Speech-Language Pathologist
  • Kinston, NC
National Provider Identifier
1235837972
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
15569 Issued in NC
Practice address
3207 Carey Rd
Kinston, NC 28504-1205
Phone
(833) 584-1823
NPI assigned
Feb 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 15569 NC Primary

Addresses

Primary practice location

3207 Carey Rd
Kinston, NC 28504-1205

Mailing address

1 Pond St
Arden, NC 28704-8500
Phone (828) 774-5222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260212002249 NC Practitioner - Qualified Speech Language Pathologist 6103306899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Broad River RehabilitationGroup PAC ID 3375801350, 210 clinicians

Practice addresses (Care Compare)

3207 Carey Rd
Kinston, NC 28504-1205
Phone (252) 558-1194

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15569NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Broad River Rehabilitation Speech-Language Pathologist CurrentSince Jan 16, 2026 Accepting new patients

Locations

1 Pond St
Arden, NC 28704
Phone 82877452220027

3207 Carey Rd
Kinston, NC 28504
Phone (252) 523-3099

915 W Cooksey Dr
Thomasville, NC 27360
Phone (336) 313-0224

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.

NPI Registry JSON

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

{
    "created_epoch": "1677024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1235837972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 POND ST",
            "city": "ARDEN",
            "state": "NC",
            "postal_code": "287048500",
            "telephone_number": "828-774-5222",
            "fax_number": "828-774-5254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3207 CAREY RD",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285041205",
            "telephone_number": "833-584-1823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEOGH",
        "first_name": "MAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-22",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "15569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kinston, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.