Active NPI
Matresa Elaine McIntyre, SLP
- Speech-Language Pathologist
- Lumberton, NC
National Provider Identifier
1508905258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 6809
- Practice address
- 4240 Fayetteville Rd
Lumberton, NC 28358-2605 - Phone
- (910) 735-1101
- Fax
- (910) 735-1103
- NPI assigned
- Feb 6, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 6809 | NC | Primary |
Addresses
Primary practice location
4240 Fayetteville Rd
Lumberton, NC 28358-2605
Mailing address
7348 Center Rd
Bladenboro, NC 28320-8621
Phone (910) 735-1101
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6809 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508905258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7348 CENTER RD",
"city": "BLADENBORO",
"state": "NC",
"postal_code": "283208621",
"telephone_number": "910-735-1101",
"fax_number": "910-735-1103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4240 FAYETTEVILLE RD",
"city": "LUMBERTON",
"state": "NC",
"postal_code": "283582605",
"telephone_number": "910-735-1101",
"fax_number": "910-735-1103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCINTYRE",
"first_name": "MATRESA",
"middle_name": "ELAINE",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "6809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lumberton, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.