NPIMap

Individual provider Active NPI

Kera Elizabeth Hayden

  • Speech-Language Pathologist
  • Mooresville, NC
National Provider Identifier
1417445495
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2204000824 Issued in VA
Practice address
134 Infield CT
Mooresville, NC 28117-8026
Phone
(704) 799-6824
Fax
(704) 799-6825
NPI assigned
Apr 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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 2204000824 VA Primary

Addresses

Primary practice location

134 Infield CT
Mooresville, NC 28117-8026

Mailing address

134 Infield CT
Mooresville, NC 28117-8026
Phone (704) 799-6824

Other practice location 1

1857 Varsity Dr
Chesapeake, VA 23324-1538
Phone (757) 494-7555

Other practice location 2

16415 Northcross Dr Ste F
Huntersville, NC 28078-5001
Phone (704) 799-6824

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
2204000824VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Holly Ridge Center Speech-Language Pathologist Past Accepting new patients
Lolly Therapeutics, LLC Speech-Language Pathologist PastSince Jan 22, 2023 Accepting new patients
Integrative Therapy Concepts PastSince Jan 22, 2023 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1417445495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 INFIELD CT",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178026",
            "telephone_number": "704-799-6824",
            "fax_number": "704-799-6825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 INFIELD CT",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178026",
            "telephone_number": "704-799-6824",
            "fax_number": "704-799-6825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1857 Varsity Dr",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233241538",
            "country_code": "US",
            "telephone_number": "757-494-7555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16415 Northcross Dr Ste F",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280785001",
            "country_code": "US",
            "telephone_number": "704-799-6824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYDEN",
        "first_name": "KERA",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-25",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2204000824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; 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.