Jo Revelle Murray Isenhour, MED CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

11157 Issued in NC

Practice address

4979 Southport Supply Rd SE
Southport, NC 28461-8742

Phone

(910) 612-1002

Fax

(910) 755-5865

NPI assigned

May 6, 2015

Last updated

Jan 26, 2021By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carolina Rehabilitation Inc

  dba Brunswick P.T. Associates, Edwards & Associates P.T.

  • Physical Medicine & Rehabilitation Physician
  • Supply, NC
  • NPI 1427142561
  NPD (past)

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

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1699152926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 SOUTHPORT SUPPLY RD SE STE 201",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284619273",
            "telephone_number": "910-612-1002",
            "fax_number": "910-755-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4979 SOUTHPORT SUPPLY RD SE",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284618742",
            "telephone_number": "910-612-1002",
            "fax_number": "910-755-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISENHOUR",
        "first_name": "JO",
        "middle_name": "REVELLE MURRAY",
        "credential": "MED CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-06",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "11157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elliott Humphries
• Diana Melisa Idelson, LCSW
• Intracoastal Executive Wellness
• Charlene D Irvin
• John D Irvin, MD
• J Arthur Dosher Memorial Hospital (Dosher Medical Atlantic Ave)
• J Arthur Dosher Memorial Hospital
• J Arthur Dosher Memorial Hospital (Dosher Medical Women's Health)
• J Arthur Dosher Memorial Hospital (Dosher Wellness Center)
• J Arthur Dosher Memorial Hospital (Dosher Wellness Center)

• Speech-Language Pathologist in Southport, NC
• Providers in Southport, 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 26, 2021; 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.