Individual provider Active NPI

Mary Carmen Kreitz

  • Speech-Language Pathologist
  • Charlotte, NC
National Provider Identifier
1245097187
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
30002608 Issued in NC
Practice address
11945 Providence Rd
Charlotte, NC 28277-4454
Phone
(704) 234-6062
NPI assigned
Mar 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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 30002608 NC Primary

Addresses

Primary practice location

11945 Providence Rd
Charlotte, NC 28277-4454

Mailing address

4100 Bannockburn PL Apt C
Charlotte, NC 28211-4500
Phone (334) 318-9577

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260214000295 NC Practitioner - Qualified Speech Language Pathologist 6204316763 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Weston Group Inc 215 clinicians
Comprehensive Therapeutics LTD 324 clinicians

Practice addresses (Care Compare)

11945 Providence Rd
Charlotte, NC 28277-4454
Phone (980) 245-2676

5114 Providence Rd
Charlotte, NC 28226-5852
Phone (980) 222-3203

7745 Little Ave
Charlotte, NC 28226-8168
Phone (704) 541-9333

980 Chestnut LN
Matthews, NC 28104-8543
Phone (980) 585-9293

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30002608NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Speech-Language Pathologist CurrentSince Jan 25, 2026 Accepting new patients
The Weston Group Inc CurrentSince Nov 2, 2025 Accepting new patients
Comprehensive Therapeutics LTD Speech-Language Pathologist CurrentSince Jan 25, 2026 Accepting new patients
The Weston Group Inc. CurrentSince Nov 2, 2025 Accepting new patients

Locations

5114 Providence Rd
Charlotte, NC 28226
Phone (704) 364-2485

2147 Davie Ave
Statesville, NC 28625
Phone (704) 878-0123

Organizations & group practices 12

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": "1709596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1245097187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 BANNOCKBURN PL APT C",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114500",
            "telephone_number": "334-318-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11945 PROVIDENCE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774454",
            "telephone_number": "704-234-6062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREITZ",
        "first_name": "MARY",
        "middle_name": "CARMEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-05",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30002608",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 5, 2024; 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.