Individual provider Active NPI

Kristen N Evans, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Raleigh, NC
National Provider Identifier
1487992533
Registry record updated Sep 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
9639 Issued in NC
Practice address
4328 Bland Rd
Raleigh, NC 27609-6125
Phone
(919) 981-6588
Fax
(919) 981-6255
NPI assigned
Jan 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2013

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 9639 NC Primary

Addresses

Primary practice location

4328 Bland Rd
Raleigh, NC 27609-6125

Mailing address

4328 Bland Rd
Raleigh, NC 27609-6125
Phone (919) 981-6588

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
9639NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Aspen Center Past Accepting new patients
The Aspen Center Inc. Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 2

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": "1358985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379635200000",
    "number": "1487992533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4328 BLAND RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096125",
            "telephone_number": "919-981-6588",
            "fax_number": "919-981-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4328 BLAND RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096125",
            "telephone_number": "919-981-6588",
            "fax_number": "919-981-6255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "KRISTEN",
        "middle_name": "N",
        "name_prefix": "Miss",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-24",
        "last_updated": "2013-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "9639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; 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.