Wake Pediatric Speech Therapy

Primary specialty

Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X

License

5439 Issued in NC

Legal business name

WAKE PEDIATRIC SPEECH THERAPY

Practice address

1157 Executive Cir Ste B1
Cary, NC 27511-4579

Phone

(919) 593-8104

Fax

(919) 882-8110

NPI assigned

Apr 3, 2014

Last updated

Apr 3, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christina Johnson, MS, CCC-SLPNPI 1124375456

Title

Speech Pathologist/Owner

Phone

(919) 593-8104

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christina Bowling Johnson, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Raleigh, NC
  • NPI 1124375456
  Authorized official Same address or phone

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396483200000",
    "number": "1366860546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1157 EXECUTIVE CIR STE B1",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275114579",
            "telephone_number": "919-593-8104",
            "fax_number": "919-882-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1157 EXECUTIVE CIR STE B1",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275114579",
            "telephone_number": "919-593-8104",
            "fax_number": "919-882-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE PEDIATRIC SPEECH THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-03",
        "last_updated": "2014-04-03",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "SPEECH PATHOLOGIST/OWNER",
        "authorized_official_telephone_number": "919-593-8104",
        "authorized_official_credential": "MS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "NC",
            "license": "5439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7413900",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wake Neurology PLLC
• Wake Neuropathy P.a. (Wake Chiropractic)
• Wake OBGYN P.a.
• Wake Ophthalmology Associates, PA
• Wake Orthopaedics, LLC
• Wake Pet Services LLC
• Wake Plastic Surgery, PLLC
• Wake Primary Care, PLLC
• Wake Psychological Associates PLLC
• Wake Specialty Physicians (WSP-Wake Orthopaedics)

• Hearing and Speech Clinic/Center in Cary, NC
• Providers in Cary, NC by specialty
• Hearing and Speech Clinic/Center in North Carolina

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