Individual provider Active NPI

Lauren Boehnlein

  • Speech-Language Pathologist
  • Clemmons, NC
National Provider Identifier
1518401587
Registry record updated Dec 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
9417 Issued in NC
Practice address
3905 Clemmons Rd
Clemmons, NC 27012-8479
Phone
(336) 766-9158
NPI assigned
Dec 11, 2016
Last updated
Dec 11, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2016

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 9417 NC Primary

Addresses

Primary practice location

3905 Clemmons Rd
Clemmons, NC 27012-8479

Mailing address

3905 Clemmons Rd
Clemmons, NC 27012-8479

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220218001632 NC Practitioner - Qualified Speech Language Pathologist 5294129144 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9417NCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Speech-Language Pathologist CurrentSince Aug 30, 2024 Accepting new patients
Functional Pathways Preferred of Tennessee LLC Speech-Language Pathologist CurrentSince Feb 1, 2022 Accepting new patients
Comprehensive Therapeutics LTD Speech-Language Pathologist CurrentSince Aug 30, 2024 Accepting new patients

Locations

5114 Providence Rd
Charlotte, NC 28226
Phone (704) 364-2485

2147 Davie Ave
Statesville, NC 28625
Phone (704) 878-0123

10133 Sherrill Blvd
Ste 200
Knoxville, TN 37932
Phone (865) 392-2849

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1481414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481414400000",
    "number": "1518401587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3905 CLEMMONS RD",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 CLEMMONS RD",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128479",
            "telephone_number": "336-766-9158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHNLEIN",
        "first_name": "LAUREN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-11",
        "last_updated": "2016-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "9417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clemmons, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.