Active NPI
Amanda Poole Wesson, CCC-SLP
- Speech-Language Pathologist
- Durham, NC
National Provider Identifier
1518205459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 9889
- Practice address
- 116 Holly Berry LN
Durham, NC 27703-2946 - Phone
- (919) 673-0976
- NPI assigned
- Jan 28, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP007903 | GA | |
| Speech-Language Pathologist | 235Z00000X | 9889 | NC | Primary |
Addresses
Primary practice location
116 Holly Berry LN
Durham, NC 27703-2946
Mailing address
116 Holly Berry LN
Durham, NC 27703-2946
Phone (919) 673-0976
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 |
|---|---|---|---|
| 9889 | NC | MD | General Practice Dentistry |
| SLP007903 | GA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467158400000",
"number": "1518205459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 HOLLY BERRY LN",
"city": "DURHAM",
"state": "NC",
"postal_code": "277032946",
"telephone_number": "919-673-0976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 HOLLY BERRY LN",
"city": "DURHAM",
"state": "NC",
"postal_code": "277032946",
"telephone_number": "919-673-0976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WESSON",
"first_name": "AMANDA",
"middle_name": "POOLE",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-28",
"last_updated": "2016-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "SLP007903",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "9889",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.