NPIMap

Organization Active NPI

Advantage Speech Therapy LLC

  • Speech-Language Pathologist
  • Raleigh, NC
National Provider Identifier
1740355262
Registry record updated Jun 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
ADVANTAGE SPEECH THERAPY LLC
Practice address
8402 Six Forks Rd Ste 101
Raleigh, NC 27615-3071
Phone
(919) 847-6773
Fax
(919) 847-6827
NPI assigned
Nov 21, 2006
Last updated
Jun 3, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2013

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

Authorized official

Name
Mr. Tim Peters
Title
Office Manager
Phone
(919) 847-6773

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

8402 Six Forks Rd Ste 101
Raleigh, NC 27615-3071

Mailing address

8402 Six Forks Rd Ste 101
Raleigh, NC 27615-3071
Phone (919) 847-6773

Other identifiers 1

IdentifierTypeStateIssuer
7411308MedicaidNC

National Provider Directory

National Provider Directory

Locations

8402 Six Forks Rd
Ste 101
Raleigh, NC 27615
Phone (919) 847-6773

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370217600000",
    "number": "1740355262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8402 SIX FORKS RD STE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153071",
            "telephone_number": "919-847-6773",
            "fax_number": "919-847-6827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8402 SIX FORKS RD STE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153071",
            "telephone_number": "919-847-6773",
            "fax_number": "919-847-6827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTAGE SPEECH THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2013-06-03",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "919-847-6773",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7411308",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; 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.