Elizabeth Rider Soboeiro, M.S.,CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3148 Issued in NC

Practice address

401 N.Main Street
Fuquay Varina, NC 27526-1933

Phone

(919) 577-6807

Fax

(919) 577-6853

NPI assigned

Feb 13, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393804800000",
    "number": "1285776419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N. MAIN STREET",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275261933",
            "telephone_number": "919-577-6807",
            "fax_number": "919-577-6853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N.MAIN STREET",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275261933",
            "telephone_number": "919-577-6807",
            "fax_number": "919-577-6853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBOEIRO",
        "first_name": "ELIZABETH",
        "middle_name": "RIDER",
        "name_prefix": "Mrs.",
        "credential": "M.S.,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2014-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "3148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1285776419",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7412177",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Fuquay Varina, NC
• Providers in Fuquay Varina, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; 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.