Individual provider Active NPI

Corrie Austin Altenburg, M.C.D., CF-SLP

  • Speech-Language Pathologist
  • North Charleston, SC
National Provider Identifier
1417325481
Registry record updated Sep 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5839 Issued in SC
Practice address
2070 Northbrook Blvd
North Charleston, SC 29406-9252
Phone
(843) 569-3033
NPI assigned
Sep 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2015

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 5839 SC Primary

Addresses

Primary practice location

2070 Northbrook Blvd
North Charleston, SC 29406-9252

Mailing address

2070 Northbrook Blvd
North Charleston, SC 29406-9252
Phone (843) 569-3033

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

State licenses

LicenseStateTypeSpecialty
5839SCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441756800000",
    "number": "1417325481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2070 NORTHBROOK BLVD",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069252",
            "telephone_number": "843-569-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2070 NORTHBROOK BLVD",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069252",
            "telephone_number": "843-569-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTENBURG",
        "first_name": "CORRIE",
        "middle_name": "AUSTIN",
        "credential": "M.C.D., CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-09",
        "last_updated": "2015-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "5839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; 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.