Active NPI
Martha Fitzsimmons Green, MA
- Speech-Language Pathologist
- Charlotte, NC
National Provider Identifier
1356620033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2955
- Practice address
- 11535 Carmel Commons Blvd
Charlotte, NC 28226-5313 - Phone
- (704) 541-3737
- NPI assigned
- Aug 11, 2011
- 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 | 2955 | NC | Primary |
Addresses
Primary practice location
11535 Carmel Commons Blvd
Charlotte, NC 28226-5313
Mailing address
1366 Weymouth LN
Charlotte, NC 28270-9770
Phone (704) 845-9246
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2955 | NC | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313020800000",
"number": "1356620033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1366 WEYMOUTH LN",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282709770",
"telephone_number": "704-845-9246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11535 CARMEL COMMONS BLVD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282265313",
"telephone_number": "704-541-3737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "MARTHA",
"middle_name": "FITZSIMMONS",
"name_prefix": "Mrs.",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-11",
"last_updated": "2011-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "2955",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.