Individual provider Active NPI

Debora Hamilton Wallace

  • Speech-Language Pathologist
  • Cary, NC
National Provider Identifier
1699617555
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1741 Issued in NC
Practice address
110 Corning Rd
Cary, NC 27518-9229
Phone
(919) 431-7400
NPI assigned
Apr 8, 2026
Last updated
Sep 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1741 NC Primary

Addresses

Primary practice location

110 Corning Rd
Cary, NC 27518-9229

Mailing address

400 Cross Lake Dr
Fuquay Varina, NC 27526-9444
Phone (919) 524-2568

Other names 1

  • Debora H Wallace Other name

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

LicenseStateTypeSpecialty
1741NCMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1775606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1699617555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CROSS LAKE DR",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275269444",
            "telephone_number": "919-524-2568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CORNING RD",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275189229",
            "telephone_number": "919-431-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "DEBORA",
        "middle_name": "HAMILTON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-08",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "1741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORA",
            "last_name": "WALLACE",
            "middle_name": "H",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; 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.