Jean Mary Fitzgibbons

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

13217 Issued in NC

Practice address

4130 Oleander Dr
Wilmington, NC 28403-6843

Phone

(910) 679-8385

Fax

(910) 679-8387

NPI assigned

Oct 23, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Coastline Therapy Group, LLC

  • Speech-Language Pathologist
  • Wilmington, NC
  • NPI 1730681388

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540252800000",
    "number": "1376019794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 PRESERVATION WAY UNIT 102",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284054356",
            "telephone_number": "201-709-0258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 OLEANDER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036843",
            "telephone_number": "910-679-8385",
            "fax_number": "910-679-8387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4130 Oleander Dr",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284036843",
            "country_code": "US",
            "telephone_number": "910-679-8385",
            "fax_number": "910-679-8387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITZGIBBONS",
        "first_name": "JEAN",
        "middle_name": "MARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-23",
        "last_updated": "2018-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "13217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynell Brooke Fisher, PTA
• Michael John Fisher, MD
• Michael Fitzgerald
• Timothy Shawn Fitzgerald, PA
• Maegan Rose Fitzgibbon, LCSWA
• Easton Victoria Fitzpatrick
• Cynthia R Fitzsimmons, PSY.D.
• Five Star Rehabilitation and Wellness Services, LLC
• Fix N' 2 Talk
• Elizabeth Faye Flack, LCAS, LPA

• Speech-Language Pathologist in Wilmington, NC
• Providers in Wilmington, 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 Oct 23, 2018; 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.