Individual provider Active NPI

Carmen Rae McElfresh, MA CCC-SLP

  • Speech-Language Pathologist
  • Fayetteville, NC
National Provider Identifier
1417046111
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5351 Issued in NC
Practice address
6958 Nexus CT
Suite 102
Fayetteville, NC 28304-2642
Phone
(910) 423-5622
Fax
(910) 423-5538
NPI assigned
Oct 12, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 5351 NC Primary

Addresses

Primary practice location

6958 Nexus CT
Suite 102
Fayetteville, NC 28304-2642

Mailing address

862 Nighthawk PL
Fayetteville, NC 28314-5653
Phone (704) 779-3223

Other identifiers 1

IdentifierTypeStateIssuer
7412578MedicaidNC

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
5351NCMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417046111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "862 NIGHTHAWK PL",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283145653",
            "telephone_number": "704-779-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6958 NEXUS CT",
            "address_2": "SUITE 102",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283042642",
            "telephone_number": "910-423-5622",
            "fax_number": "910-423-5538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCELFRESH",
        "first_name": "CARMEN",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "5351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7412578",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.