Jennifer Sheargold, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

12292 Issued in NC

Practice address

4130 Oleander Dr Ste 101
Wilmington, NC 28403-6844

Phone

(910) 679-8385

Fax

(910) 679-8387

NPI assigned

Jul 24, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Coastal Speech and Reading Center

  • Speech-Language Pathologist
  • Lumberton, NC
  • NPI 1649626466
  NPD (past)

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1407086408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 OLEANDER DR STE 101",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036844",
            "telephone_number": "910-679-8385",
            "fax_number": "910-679-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 OLEANDER DR STE 101",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036844",
            "telephone_number": "910-679-8385",
            "fax_number": "910-679-8387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11635 Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441064319",
            "country_code": "US",
            "telephone_number": "216-231-8787",
            "fax_number": "216-231-7141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEARGOLD",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-24",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "12292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1564187",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Makeba Sharice Shaw, MA, LPC
• Bassam Abdul-Qadir Shawamreh, MD
• Shawn M. Conrad, D.D.S., P.a.
• Sophia Isabel Shea, LCSW-A
• Luanne Gardner Sheaffer, PA-C
• Amy Shearin
• Jenna Shearl, LCSW
• Bobbie Lee Sheatsley, CRNA
• Casey Gene Sheck, D.O.
• Lydia Beth Shedlofsky, DO

• 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 Dec 3, 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.