Active NPI
Gina Federal Weise, MSP, CCC-SLP
- Speech-Language Pathologist
- Charlotte, NC
National Provider Identifier
1679091730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 6375
- Practice address
- 3205 Freedom Dr Ste 7500
Charlotte, NC 28208-3490 - Phone
- (980) 280-6526
- NPI assigned
- Sep 8, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 6375 | SC | Primary |
Addresses
Primary practice location
3205 Freedom Dr Ste 7500
Charlotte, NC 28208-3490
Mailing address
4921 Grace View Dr
Pineville, NC 28134-7485
Phone (704) 661-6456
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6375 | SC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580256000000",
"number": "1679091730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4921 GRACE VIEW DR",
"city": "PINEVILLE",
"state": "NC",
"postal_code": "281347485",
"telephone_number": "704-661-6456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3205 FREEDOM DR STE 7500",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282083490",
"telephone_number": "980-280-6526"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISE",
"first_name": "GINA",
"middle_name": "FEDERAL",
"credential": "MSP, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-08",
"last_updated": "2020-01-29",
"certification_date": "2020-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "SC",
"license": "6375",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.