Individual provider Active NPI

Sherry Nowack, CCC-SLP

  • Speech-Language Pathologist
  • Fayetteville, NC
National Provider Identifier
1720971211
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
30005019 Issued in NC
Practice address
934 Cambridge St
Fayetteville, NC 28303-5300
Phone
(910) 493-3555
Fax
(910) 493-3520
NPI assigned
Jun 2, 2025
Last updated
Jul 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 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 30005019 NC Primary

Addresses

Primary practice location

934 Cambridge St
Fayetteville, NC 28303-5300

Mailing address

920 Cambridge St
Fayetteville, NC 28303-5300
Phone (910) 493-3555

Other practice location 1

920 Cambridge St
Fayetteville, NC 28303-5300
Phone (910) 493-3555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260429000538 NC Practitioner - Qualified Speech Language Pathologist 0244707149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

934 Cambridge St
Fayetteville, NC 28303-5300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
A New Leaf Therapeutic Services, PLLC CurrentSince Jun 8, 2025 Accepting new patients

Locations

920 Cambridge St
Fayetteville, NC 28303
Phone (910) 493-3555

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1748822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1720971211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 CAMBRIDGE ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035300",
            "telephone_number": "910-493-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "934 CAMBRIDGE ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035300",
            "telephone_number": "910-493-3555",
            "fax_number": "910-493-3520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Cambridge St",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283035300",
            "country_code": "US",
            "telephone_number": "910-493-3555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOWACK",
        "first_name": "SHERRY",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-02",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30005019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.