Village Rehabilitation and Consulting Clinic, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

VILLAGE REHABILITATION AND CONSULTING CLINIC, LLC

Practice address

5420 Covington Cross Dr
Knightdale, NC 27545-7601

Phone

(919) 247-4821

NPI assigned

Nov 24, 2014

Organization subpart

No

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

Authorized official

Name

Tyrone McRae

Title

Member/Organizer

Phone

(919) 247-4821

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1416787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416787200000",
    "number": "1427455153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5420 COVINGTON CROSS DR",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275457601",
            "telephone_number": "919-247-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5420 COVINGTON CROSS DR",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275457601",
            "telephone_number": "919-247-4821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE REHABILITATION AND CONSULTING CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-24",
        "last_updated": "2014-11-24",
        "status": "A",
        "authorized_official_last_name": "MCRAE",
        "authorized_official_first_name": "TYRONE",
        "authorized_official_title_or_position": "MEMBER/ORGANIZER",
        "authorized_official_telephone_number": "919-247-4821"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; 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.