Individual provider Active NPI

Avery Jo Morgan, MS CCC-SLP

  • Speech-Language Pathologist
  • Fayetteville, NC
National Provider Identifier
1275214249
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
30002181 Issued in NC
Practice address
1289 Oliver St
Fayetteville, NC 28304-4450
Phone
(910) 483-8331
Fax
(910) 483-8335
NPI assigned
Jul 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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 30002181 NC Primary

Addresses

Primary practice location

1289 Oliver St
Fayetteville, NC 28304-4450

Mailing address

PO Box 87294
Fayetteville, NC 28304-7294
Phone (910) 483-8331

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

LicenseStateTypeSpecialty
30002181NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Developmental Therapy Speech-Language Pathologist PastSince Aug 6, 2023 Accepting new patients
Pediatric Developmental Therapy PastSince Aug 6, 2023 Accepting new patients

Organizations & group practices 2

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": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1275214249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87294",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283047294",
            "telephone_number": "910-483-8331",
            "fax_number": "910-483-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1289 OLIVER ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044450",
            "telephone_number": "910-483-8331",
            "fax_number": "910-483-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORGAN",
        "first_name": "AVERY",
        "middle_name": "JO",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30002181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.