Active NPI
Teresa Kenney, MA, CCC-SLP
- Speech-Language Pathologist
- Shallotte, NC
National Provider Identifier
1720525801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 11843
- Practice address
- 4902 Main St Ste D
Shallotte, NC 28470-4502 - Phone
- (910) 754-3484
- Fax
- (910) 754-3485
- NPI assigned
- Jan 26, 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 | 11843 | NC | Primary |
Addresses
Primary practice location
4902 Main St Ste D
Shallotte, NC 28470-4502
Mailing address
PO Box 1288
Lumberton, NC 28359-1288
Phone (910) 671-9629
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11843 | NC | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485388800000",
"number": "1720525801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1288",
"city": "LUMBERTON",
"state": "NC",
"postal_code": "283591288",
"telephone_number": "910-671-9629",
"fax_number": "910-671-9630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4902 MAIN ST STE D",
"city": "SHALLOTTE",
"state": "NC",
"postal_code": "284704502",
"telephone_number": "910-754-3484",
"fax_number": "910-754-3485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEY",
"first_name": "TERESA",
"credential": "MA, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-26",
"last_updated": "2017-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "11843",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shallotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.