Active NPI
Anne Holland Wallwork, SLP
- Speech-Language Pathologist
- Raleigh, NC
National Provider Identifier
1275698151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 6844
- Practice address
- 4201 Lake Boone Trail
Suite 4
Raleigh, NC 27607-7511 - Phone
- (919) 781-4434
- Fax
- (919) 781-5851
- NPI assigned
- Dec 22, 2006
- 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 | 6844 | NC | Primary |
Addresses
Primary practice location
4201 Lake Boone Trail
Suite 4
Raleigh, NC 27607-7511
Mailing address
4201 Lake Boone Trail S
Suite 4
Raleigh, NC 27607-7511
Phone (919) 781-4434
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7412338 | Medicaid | NC | |
| 4600072 | Other | UNITED HEALTHCARE | |
| 7117612 | Other | AETNA | |
| 13926 | Other | NC | BCBS |
| 8300041K | Other | NC | MEDICAID CBRS |
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 |
|---|---|---|---|
| 6844 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Therapy Associates | Speech-Language Pathologist | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Physical Therapist
- Raleigh, NC
- NPI 1447310958
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275698151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4201 LAKE BOONE TRAIL S",
"address_2": "SUITE 4",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276077511",
"telephone_number": "919-781-4434",
"fax_number": "919-781-5851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4201 LAKE BOONE TRAIL",
"address_2": "SUITE 4",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276077511",
"telephone_number": "919-781-4434",
"fax_number": "919-781-5851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLWORK",
"first_name": "ANNE",
"middle_name": "HOLLAND",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "6844",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7412338",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "4600072",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7117612",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "13926",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID CBRS",
"identifier": "8300041K",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.