Shanna Bond Raynor

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

30003974 Issued in NC

Practice address

112 Medical Village Dr Ste a
Wallace, NC 28466-1665

Phone

(910) 299-0700

Fax

(910) 299-0800

NPI assigned

Aug 11, 2025

Last updated

Aug 11, 2025By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Speech and Language Rehabilitation Services, Inc.

  • Speech-Language Pathologist
  • Clinton, NC
  • NPI 1891858692
  NPD (past)

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

{
    "created_epoch": "1754870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1255217899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1414",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283291414",
            "telephone_number": "910-299-0700",
            "fax_number": "910-299-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MEDICAL VILLAGE DR STE A",
            "city": "WALLACE",
            "state": "NC",
            "postal_code": "284661665",
            "telephone_number": "910-299-0700",
            "fax_number": "910-299-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYNOR",
        "first_name": "SHANNA",
        "middle_name": "BOND",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-11",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30003974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlie Powell
• Megan Carlton Powell, DPT
• Dametri Pratt
• Premise Health of North Carolina Medical PC (House of Raeford Health & Wellness Center)
• Lauren Prentice, PHARMD
• Realo Discount Drug Stores of Eastern North Carolina, Inc (Realo Discount Drugs)
• Daniel Michael Ricci, M.D.
• Donna Roberts Rice, RPH
• J Daniel Robinson III, OD
• Carrie Kyper Royer, PA-C

• Speech-Language Pathologist in Wallace, NC
• Providers in Wallace, 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 Aug 11, 2025; 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.