Active NPI
Carol Greenwald
- Speech-Language Pathologist
- Memphis, TN
National Provider Identifier
1265615678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 0000002855
- Practice address
- 324 Buena Vista PL
Memphis, TN 38112-5400 - Phone
- (901) 278-1556
- Fax
- (901) 278-1556
- NPI assigned
- Dec 7, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 0000002855 | TN | Primary |
Addresses
Primary practice location
324 Buena Vista PL
Memphis, TN 38112-5400
Mailing address
324 Buena Vista PL
Memphis, TN 38112-5400
Phone (901) 278-1556
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SP0000002855 | Other | TN | LICENSE |
| 00784991 | Other | ASHA CERTIFICATION | |
| SP481 | Other | AR | LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0000002855 | TN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196985600000",
"number": "1265615678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "324 BUENA VISTA PL",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381125400",
"telephone_number": "901-278-1556",
"fax_number": "901-278-1556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "324 BUENA VISTA PL",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381125400",
"telephone_number": "901-278-1556",
"fax_number": "901-278-1556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENWALD",
"first_name": "CAROL",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-07",
"last_updated": "2007-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TN",
"license": "0000002855",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "SP0000002855",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASHA CERTIFICATION",
"identifier": "00784991",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "SP481",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.