Jordan Gristock
Individual provider Active NPI Speech-Language Pathologist · Charlotte, NC
NPI 1669948600 · NPPES record last updated Oct 17, 2018
Key facts
- NPI
- 1669948600
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- Practice address
- 427 N Wendover Rd
Charlotte, NC 28211-1064 - Phone
- (704) 304-0620
- NPI assigned
- Oct 17, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolinas Rehabilitation | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Yes |
Addresses
Primary practice location
427 N Wendover Rd
Charlotte, NC 28211-1064
Mailing address
2104 Park Rd Apt 3
Charlotte, NC 28203-5963
Other providers in Charlotte, NC
- Molly Elizabeth Grimm
- Julia Grinchak
- Taras A Grinchak
- Valentina G Grinchak
- Keleigh Clare Grinham
- Elizabeth J Griswold
- Mollie Elizabeth Griswold
- Nancy Gritter
- GRL Care Providers, LLC
- Stephanie Grobe
All providers in Charlotte, NC · Speech-Language Pathologist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.