Raluca Madalina Nicodim

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

15133 Issued in NC

Practice address

900 S Franklin St Ste 201
Wake Forest, NC 27587-2799

Phone

(919) 556-1700

NPI assigned

Apr 18, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peak Performance Sports and Physical Therapy LLCGroup PAC ID 0749276426, 60 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Peak Performance Sports and Physical Therapy, LLC

  • Physical Therapist
  • New Bern, NC
  • NPI 1194714063

  Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1429315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1457748337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S FRANKLIN ST STE 201",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275872799",
            "telephone_number": "919-556-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S FRANKLIN ST STE 201",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275872799",
            "telephone_number": "919-556-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICODIM",
        "first_name": "RALUCA",
        "middle_name": "MADALINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-18",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "CA",
            "license": "1938",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "15133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eunice Wanjiru Ngumba-Gatabaki, PHD
• Nguyen & Nguyen Dentistry Partnership
• Nguyen and Mulnick PLLC
• CHI Minh Nguyen, PA
• Tran Minhthi Nguyen, D.D.S.
• Nina Thomas, DDS, PLLC
• Judy Njoroge, NURSE PRACTITIONER
• Sarah A Noland, LCSW
• Anna Kaleigh Norman, PA-C
• Hilary Leath Norris, LCSW

• Speech-Language Pathologist in Wake Forest, NC
• Providers in Wake Forest, 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 Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.