Individual provider Active NPI

Heather Ann Corica

  • Speech-Language Pathologist
  • Tega Cay, SC
National Provider Identifier
1669138392
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7897 Issued in SC
Practice address
111 Wellmore Dr
Tega Cay, SC 29708-0124
Phone
(803) 835-7000
NPI assigned
Nov 17, 2021
Last updated
Mar 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 15126 NC
Speech-Language Pathologist 235Z00000X 7897 SC Primary

Addresses

Primary practice location

111 Wellmore Dr
Tega Cay, SC 29708-0124

Mailing address

111 Wellmore Dr
Tega Cay, SC 29708-0124

Other practice location 1

1460 Babcock Dr
Winston Salem, NC 27106-2632
Phone (732) 887-2355

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
7897SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Outpatient Rehabilitation Services, LLC CurrentSince Aug 5, 2022 Accepting new patients
Paragon Outpatient Rehabilitation Services, LLC Single Specialty CurrentSince Aug 5, 2022 Accepting new patients

Locations

1195 Drake Mill Ln SW
Concord, NC 28025
Phone (704) 251-2602

2605 Swallow Rd
Rm 201
Reidsville, NC 27320
Phone (704) 251-2602

Organizations & group practices 2

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": "1637107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1669138392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WELLMORE DR",
            "city": "TEGA CAY",
            "state": "SC",
            "postal_code": "297080124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WELLMORE DR",
            "city": "TEGA CAY",
            "state": "SC",
            "postal_code": "297080124",
            "telephone_number": "803-835-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1460 Babcock Dr",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271062632",
            "country_code": "US",
            "telephone_number": "732-887-2355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORICA",
        "first_name": "HEATHER",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-17",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "15126",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "7897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tega Cay, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.