Theracomm Speech Therapy SVCS

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

1514 Issued in NC

Legal business name

THERACOMM SPEECH THERAPY SVCS

Practice address

6204 Lake Trail Drive
Fayetteville, NC 28304-0502

Phone

(910) 482-4819

Fax

(910) 482-0637

NPI assigned

Jul 31, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Gloria F Rogers, MS CCC SLP

Title

Owner

Phone

(910) 482-4819

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Theracomm Speech Therapy Services LLC Other name

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1518972041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6204 LAKE TRAIL DRIVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283040502",
            "telephone_number": "910-482-4819",
            "fax_number": "910-482-0637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6204 LAKE TRAIL DRIVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283040502",
            "telephone_number": "910-482-4819",
            "fax_number": "910-482-0637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERACOMM SPEECH THERAPY SVCS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-482-4819",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS CCC SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "1514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7411025",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BCBS",
            "identifier": "72828",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Theracomm Speech Therapy Services LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Speech-Language Pathologist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.