Individual provider Active NPI

Bethany Sue Krek, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Wilmington, NC
National Provider Identifier
1457820201
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
14222 Issued in NC
Practice address
5002 Randall Pkwy Ste 102
Wilmington, NC 28403-2829
Phone
(301) 331-1335
Fax
(910) 500-0126
NPI assigned
Nov 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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 14222 NC Primary

Addresses

Primary practice location

5002 Randall Pkwy Ste 102
Wilmington, NC 28403-2829

Mailing address

3713 Stormy Gale PL
Castle Hayne, NC 28429-6234
Phone (301) 331-1335

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
14222NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Anchored Therapy Services, PLLC Speech-Language Pathologist CurrentSince Aug 1, 2023 Accepting new patients
Washington County Early Intervention Speech-Language Pathologist PastSince Sep 12, 2021 Accepting new patients
Board of Education of Washington County Speech-Language Pathologist PastSince Sep 12, 2021 Accepting new patients

Locations

432 Eastwood Rd
Ste 1C
Wilmington, NC 28403

5002 Randall Pkwy
Ste 102
Wilmington, NC 28403
Phone (301) 331-1335

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": "1542758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1457820201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3713 STORMY GALE PL",
            "city": "CASTLE HAYNE",
            "state": "NC",
            "postal_code": "284296234",
            "telephone_number": "301-331-1335",
            "fax_number": "910-500-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5002 RANDALL PKWY STE 102",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032829",
            "telephone_number": "301-331-1335",
            "fax_number": "910-500-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREK",
        "first_name": "BETHANY",
        "middle_name": "SUE",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-21",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "14222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; 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.