Pediatric Therapeutic Coaching

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5556 Issued in SC

Legal business name

PEDIATRIC THERAPEUTIC COACHING

Practice address

1301 Rolling Hills CT
Concord, NC 28025-9148

Phone

(704) 787-0224

NPI assigned

Dec 1, 2014

Organization subpart

No

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

Authorized official

Name

Susan M Walters, MA CCC SLPNPI 1346204708

Title

Speech/Language Pathologist

Phone

(704) 787-0224

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Pediatric Therapeutic Coaching Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan M Walters, MA, CCC-SLP

  • Speech-Language Pathologist
  • Concord, NC
  • NPI 1346204708
  NPD (past) Authorized official

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

{
    "created_epoch": "1417392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417392000000",
    "number": "1346647799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1171 MARKET ST",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297086500",
            "telephone_number": "704-787-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 ROLLING HILLS CT",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280259148",
            "telephone_number": "704-787-0224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC THERAPEUTIC COACHING",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-01",
        "last_updated": "2014-12-01",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SPEECH/LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "704-787-0224",
        "authorized_official_credential": "MA CCC SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "5556",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "7056",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1346204708",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Therapeutic Coaching",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelley Perkins Peacock
• Peak Wellness Clinic PLLC
• Fay Matlock Pearson, RN
• Michele Lee Pearson, PT
• Tindall Pearson, LCSWA, MSW
• Fernanda Noleto Pedrosa, DO
• Lachundra Pemberton
• Corey L Pena, C.O.
• Karime Penunuri
• Jessica Ann Peoples, PA

• Speech-Language Pathologist in Concord, NC
• Providers in Concord, 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 Dec 1, 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.