Individual provider Active NPI

Emma Peterson

  • Speech-Language Pathologist
  • Cornelius, NC
National Provider Identifier
1275252405
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
30001923 Issued in NC
Practice address
19530 Mt Zion Pkwy
Cornelius, NC 28031-8398
Phone
(704) 997-2970
NPI assigned
Aug 23, 2022
Last updated
Aug 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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 30001923 NC Primary

Addresses

Primary practice location

19530 Mt Zion Pkwy
Cornelius, NC 28031-8398

Mailing address

1327 Bexton St Apt 307
Charlotte, NC 28273-5096
Phone (860) 391-1870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230629002841 NC Practitioner - Qualified Speech Language Pathologist 3971962598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Collective Therapy CorpGroup PAC ID 0143651802, 75 clinicians

Practice addresses (Care Compare)

507 Wakefield Dr
Apt C
Charlotte, NC 28209-3148
Phone (704) 285-8207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Collective Therapy Corp. Speech-Language Pathologist CurrentSince Jun 12, 2023 Accepting new patients

Locations

8919 Park Rd
Charlotte, NC 28210
Phone (704) 384-1225

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1275252405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 BEXTON ST APT 307",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282735096",
            "telephone_number": "860-391-1870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19530 MT ZION PKWY",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280318398",
            "telephone_number": "704-997-2970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "EMMA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30001923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornelius, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.