Individual provider Active NPI

Meredith Busick Massenburg, SLP

  • Speech-Language Pathologist
  • Goldsboro, NC
National Provider Identifier
1376998088
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1605111 Issued in NC
Practice address
1506 Wayne Memorial Dr
Goldsboro, NC 27534-2202
Phone
(828) 371-7778
NPI assigned
May 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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 1605111 NC Primary

Addresses

Primary practice location

1506 Wayne Memorial Dr
Goldsboro, NC 27534-2202

Mailing address

102 Ingram Fields Dr
Goldsboro, NC 27530-9642
Phone (828) 371-7778

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
11977NCMDDentist
1605111NCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1462060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1376998088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 INGRAM FIELDS DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275309642",
            "telephone_number": "828-371-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 WAYNE MEMORIAL DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275342202",
            "telephone_number": "828-371-7778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSENBURG",
        "first_name": "MEREDITH",
        "middle_name": "BUSICK",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-01",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "1605111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; 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.