Individual provider Active NPI

Katrina L. Brewington, SPEECH LANGUAGE PATH

  • Speech-Language Pathologist
  • Lumberton, NC
National Provider Identifier
1386953610
Registry record updated Oct 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8442 Issued in NC
Practice address
4260 Fayetteville Rd
Lumberton, NC 28358-2711
Phone
(910) 671-9629
Fax
(910) 671-9630
NPI assigned
Oct 5, 2010
Last updated
Oct 5, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2010

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 8442 NC Primary

Addresses

Primary practice location

4260 Fayetteville Rd
Lumberton, NC 28358-2711

Mailing address

PO Box 1288
Lumberton, NC 28359-1288
Phone (910) 671-9629

Other identifiers 1

IdentifierTypeStateIssuer
8442OtherNCSPEECH LANGUAGE PATHOLOGIST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120914000737 NC Practitioner - Qualified Speech Language Pathologist 6709034838 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8442NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Speechfundamentals PLLC Speech-Language Pathologist CurrentSince Jul 30, 2012 Accepting new patients
Speech Solutions Inc Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286236800000",
    "number": "1386953610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1288",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283591288",
            "telephone_number": "910-671-9629",
            "fax_number": "910-671-9630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4260 FAYETTEVILLE RD",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283582711",
            "telephone_number": "910-671-9629",
            "fax_number": "910-671-9630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWINGTON",
        "first_name": "KATRINA",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "SPEECH LANGUAGE PATH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-05",
        "last_updated": "2010-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "8442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH LANGUAGE PATHOLOGIST",
            "identifier": "8442",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lumberton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.