NPIMap

Organization Active NPI

Nourished Roots Therapy Services

  • Speech-Language Pathologist
  • Southern Pines, NC
National Provider Identifier
1699551101
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
NOURISHED ROOTS THERAPY SERVICES
Practice address
1271 Old US 1 Hwy Unit B
Southern Pines, NC 28387-6308
Phone
(910) 310-9479
NPI assigned
Aug 31, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Authorized official

Name
Jena Leigh Southerland, MS, CCC-SLP, CLCNPI 1134603533
Title
Speech- Language Pathologist
Phone
(910) 310-9479

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN)Group: 193200000X MULTI-SPECIALTY GROUP 174N00000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

1271 Old US 1 Hwy Unit B
Southern Pines, NC 28387-6308

Mailing address

1271 Old US 1 Hwy Unit B
Southern Pines, NC 28387-6308
Phone (910) 310-9479

National Provider Directory

National Provider Directory

Locations

1271 Old US 1 Hwy
Unit B
Southern Pines, NC 28387
Phone (910) 310-9479

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753920000000",
    "number": "1699551101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1271 OLD US 1 HWY UNIT B",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283876308",
            "telephone_number": "910-310-9479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1271 OLD US 1 HWY UNIT B",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283876308",
            "telephone_number": "910-310-9479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOURISHED ROOTS THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-31",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A",
        "authorized_official_last_name": "SOUTHERLAND",
        "authorized_official_first_name": "JENA",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "SPEECH- LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "910-310-9479",
        "authorized_official_credential": "MS, CCC-SLP, CLC"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southern Pines, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; 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.