Shanna Grace Caldwell

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

30004371 Issued in NC

Practice address

325 Sound Rd Ste 200
Holly Ridge, NC 28445-7813

Phone

(910) 541-3636

NPI assigned

Jul 30, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Tidal Therapy Solutions LLC

  • Occupational Therapist
  • Hampstead, NC
  • NPI 1851010698

  Speech-Language Pathologist

  Medicare reassignment NPD

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

{
    "created_epoch": "1753833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1598648123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7321 TOPWATER DR APT 104",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284110058",
            "telephone_number": "256-808-4657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 SOUND RD STE 200",
            "city": "HOLLY RIDGE",
            "state": "NC",
            "postal_code": "284457813",
            "telephone_number": "910-541-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "SHANNA",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-30",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30004371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Bergeron
• Timothy Keith Berrey
• Kathleen Mary Bornarth, LCMHC
• Summer L Bowman
• Hallie Rebecca Brooks
• Samantha Joyce Carter, MSW, LCSW-A
• Lachelle Chapman, DPT
• Caitlin Chaussee, LMBT
• Coastal Carolina CPR LLC.
• Samantha J Cody

• Speech-Language Pathologist in Holly Ridge, NC
• Providers in Holly Ridge, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.