Individual provider Active NPI

Michelle L Thompson, MS CCC-SLP

  • Speech-Language Pathologist
  • Fuquay Varina, NC
National Provider Identifier
1700809324
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
9394 Issued in NC
Practice address
201 E Academy St Ste 103
Fuquay Varina, NC 27526-2248
Phone
(984) 381-5778
Fax
(919) 285-2475
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 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 9394 NC Primary

Addresses

Primary practice location

201 E Academy St Ste 103
Fuquay Varina, NC 27526-2248

Mailing address

9933 Clayton Blvd
Clayton, NC 27520-2113
Phone (720) 369-5266

Other practice location 1

9933 Clayton Blvd
Clayton, NC 27520-2113
Phone (720) 369-5266

Other practice location 2

364 S Nc 16 Business Hwy Ste 100
Stanley, NC 28164-8834
Phone (720) 369-5266

Other identifiers 2

IdentifierTypeStateIssuer
9394OtherNCSTATE LICENSE
07003114MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211230000728 NC Practitioner - Qualified Speech Language Pathologist 3577954569 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
9394NCMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Kidology, Inc CurrentSince Nov 1, 2021 Accepting new patients
Pediatric Connections PLLC Current Accepting new patients
Pediatric Boulevard, PLLC Speech-Language Pathologist Past Accepting new patients

Locations

201 E Academy St
Ste 103
Fuquay Varina, NC 27526
Phone (984) 381-5778

1244 N Flint St
Lincolnton, NC 28092
Phone (704) 740-0676

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1700809324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9933 CLAYTON BLVD",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275202113",
            "telephone_number": "720-369-5266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E ACADEMY ST STE 103",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262248",
            "telephone_number": "984-381-5778",
            "fax_number": "919-285-2475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9933 Clayton Blvd",
            "address_purpose": "LOCATION",
            "city": "Clayton",
            "state": "NC",
            "postal_code": "275202113",
            "country_code": "US",
            "telephone_number": "720-369-5266",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "364 S Nc 16 Business Hwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Stanley",
            "state": "NC",
            "postal_code": "281648834",
            "country_code": "US",
            "telephone_number": "720-369-5266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "9394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "9394",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07003114",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fuquay Varina, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.