Carolina Children's Therapy

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3916 Issued in NC

Legal business name

CAROLINA CHILDREN'S THERAPY

Practice address

8031 US Bus Hwy 70 W
Clayton, NC 27520-4807

Phone

(919) 630-9040

Fax

(919) 553-3836

NPI assigned

Feb 21, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Lisa Hales Brogdon, M.S.,CCC-SLPNPI 1508982307

Title

Director

Phone

(919) 630-9040

Specialties & licenses 6

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lisa Hales Brogdon, MS,CCC-SLP

  • Speech-Language Pathologist
  • Clayton, NC
  • NPI 1508982307
  NPD (past) Authorized official

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354665600000",
    "number": "1417092925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8031 US BUS HWY 70 W",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275204807",
            "telephone_number": "919-630-9040",
            "fax_number": "919-553-3836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8031 US BUS HWY 70 W",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275204807",
            "telephone_number": "919-630-9040",
            "fax_number": "919-553-3836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA CHILDREN'S THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2012-12-05",
        "status": "A",
        "authorized_official_last_name": "BROGDON",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "HALES",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "919-630-9040",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S.,CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NC",
            "license": "1468",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "3916",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "6445",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "5846",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "3429",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "8686",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7210782",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP PROVIDER NUMBE",
            "identifier": "011NU",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meredith Paige Capps, LCAS-A
• Cardinal Therapy Services PLLC
• Cardiology Associates of Johnston, PLLC
• Carelinc Medical Equipment & Supply Co LLC
• Careway Care and Transport, LLC
• Carolina Chiropractic Clinic, PC
• Carolina Decompression and Physical Therapy LLC (Carolina Spine & Disc Center)
• Carolina Dermatology and Endocrinology, PA
• Carolina Foot Specialists
• Carolina Outreach, LLC

• Speech-Language Pathologist in Clayton, NC
• Providers in Clayton, 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 5, 2012; 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.