Stacy Corey Eidson, M.S., CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5062 Issued in NC

Practice address

600 Mayfair Dr
Rocky Mount, NC 27803-1180

Phone

(252) 443-7554

NPI assigned

Jan 28, 2008

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Eidson Speech and Language Services

  • Hearing and Speech Clinic/Center
  • Rocky Mount, NC
  • NPI 1104062710
  NPD (past) Authorized official

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201478400000",
    "number": "1629255054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MAYFAIR DR",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278031180",
            "telephone_number": "252-443-7554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MAYFAIR DR",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278031180",
            "telephone_number": "252-443-7554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIDSON",
        "first_name": "STACY",
        "middle_name": "COREY",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-28",
        "last_updated": "2008-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "5062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Educare Community Living Corporation North Carolina
• Edwards Enterprises Inc (Edwards Residential Care)
• Carolyn Robards Eggers, M.A., C.A.S.
• Nelson Richard Ehly, P.A.
• Eidson Speech and Language Services
• Elizabeth E Miller DDS Ms PA (Rocky Mount Pediatric Dentistry)
• Jonta Elliott
• Willard Jackson Ellis Jr., DDS
• Randa Ibrahim Elsayed, MASTER'S DEGREE
• Hesham F Elwan

• Speech-Language Pathologist in Rocky Mount, NC
• Providers in Rocky Mount, 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 Jan 28, 2008; 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.