Individual provider Active NPI

Courtnie Faust Spinola, CCC-SLP

  • Speech-Language Pathologist
  • Wilmington, NC
National Provider Identifier
1306066733
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
6907 Issued in NC
Practice address
4243 Pine Hollow Rd
Wilmington, NC 28412-2271
Phone
(910) 792-1821
Fax
(806) 398-1821
NPI assigned
Apr 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 6907 NC Primary

Addresses

Primary practice location

4243 Pine Hollow Rd
Wilmington, NC 28412-2271

Mailing address

4243 Pine Hollow Rd
Wilmington, NC 28412-2271
Phone (910) 792-1821

Other identifiers 1

IdentifierTypeStateIssuer
7412541MedicaidNC

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

LicenseStateTypeSpecialty
6907NCMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306066733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4243 PINE HOLLOW RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122271",
            "telephone_number": "910-792-1821",
            "fax_number": "806-398-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4243 PINE HOLLOW RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284122271",
            "telephone_number": "910-792-1821",
            "fax_number": "806-398-1821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPINOLA",
        "first_name": "COURTNIE",
        "middle_name": "FAUST",
        "name_prefix": "Ms.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "6907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7412541",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, 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.

Verify at the official NPI Registry.