Individual provider Active NPI

Mary-Elizabeth Byorick Tippette, MSP, CCC-SLP

  • Speech-Language Pathologist
  • Winston Salem, NC
National Provider Identifier
1245642982
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
9073 Issued in NC
Practice address
4045 University Pkwy
Winston Salem, NC 27106-3325
Phone
(828) 577-1094
Fax
(833) 924-1004
NPI assigned
May 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 013275 GA
Speech-Language Pathologist 235Z00000X 9073 NC Primary

Addresses

Primary practice location

4045 University Pkwy
Winston Salem, NC 27106-3325

Mailing address

3621 Wickersham LN
Winston Salem, NC 27106-3583
Phone (828) 577-1094

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

LicenseStateTypeSpecialty
9073NCMDOccupational Therapist
013275GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Auditory Verbal Center Inc PastSince May 1, 2022 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.

NPI Registry JSON

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1245642982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 WICKERSHAM LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063583",
            "telephone_number": "828-577-1094",
            "fax_number": "833-924-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 UNIVERSITY PKWY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063325",
            "telephone_number": "828-577-1094",
            "fax_number": "833-924-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPPETTE",
        "first_name": "MARY-ELIZABETH",
        "middle_name": "BYORICK",
        "name_prefix": "Mrs.",
        "credential": "MSP, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-29",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "013275",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "9073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.