Active NPI
Laura Graham, MS, CCC-SLP
- Speech-Language Pathologist
- Wilson, NC
National Provider Identifier
1255391405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2689
- Practice address
- 1705 Westbrook Dr NW
Wilson, NC 27896-1567 - Phone
- (252) 281-4386
- NPI assigned
- Mar 23, 2006
- Last updated
- Aug 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2689 | OK | Primary |
Addresses
Primary practice location
1705 Westbrook Dr NW
Wilson, NC 27896-1567
Mailing address
1705 Westbrook Drive
Wilson, NC 27896
Phone (252) 281-4386
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200038510A | Medicaid | OK |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2689 | OK | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186963200000",
"number": "1255391405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1705 WESTBROOK DRIVE",
"city": "WILSON",
"state": "NC",
"postal_code": "27896",
"telephone_number": "252-281-4386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1705 WESTBROOK DR NW",
"city": "WILSON",
"state": "NC",
"postal_code": "278961567",
"telephone_number": "252-281-4386"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "LAURA",
"credential": "MS, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-23",
"last_updated": "2007-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OK",
"license": "2689",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200038510A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilson, NC
- Katie Leigh Goulet, PHARM.D., MSCR, BS
- Cameron Flores Goyette
- Grace 4 the Youth LLC.
- Sandra Ann Grace, LCAS
- Graceland Student Services LLC
- Sheryl Lashell Green, LMBT
- Gregory E Edwards (Pleasant Pine Family Care)
- Robert D Gregory, PH.D.
- Keesha Grice, LCMHCA, LCASA
- Claire Kathryn Griffith, PHYSICIAN ASSISTANT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.