Organization Active NPI

Speech Stars - Speech Therapy, PLLC

  • Speech-Language Pathologist
  • Knightdale, NC
National Provider Identifier
1740726884
Registry record updated Jan 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8844 Issued in NC
Legal business name
SPEECH STARS - SPEECH THERAPY, PLLC
Practice address
1116 Kingman Dr
Knightdale, NC 27545-6123
Phone
(919) 451-8729
Fax
(919) 295-1199
NPI assigned
Jan 12, 2017
Last updated
Jan 12, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2017

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

Authorized official

Name
Mrs. Courtnee A. R. Roulhac, M.ED., CCC-SLPNPI 1205065448
Title
Owner/Speech-Language Pathologist
Phone
(919) 451-8729

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 8844 NC Primary

Addresses

Primary practice location

1116 Kingman Dr
Knightdale, NC 27545-6123

Mailing address

1116 Kingman Dr
Knightdale, NC 27545-6123
Phone (919) 451-8729

Other identifiers 1

IdentifierTypeStateIssuer
1205065448MedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484179200000",
    "number": "1740726884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 KINGMAN DR",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275456123",
            "telephone_number": "919-451-8729",
            "fax_number": "919-295-1199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 KINGMAN DR",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275456123",
            "telephone_number": "919-451-8729",
            "fax_number": "919-295-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEECH STARS - SPEECH THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-12",
        "last_updated": "2017-01-12",
        "status": "A",
        "authorized_official_last_name": "ROULHAC",
        "authorized_official_first_name": "COURTNEE",
        "authorized_official_middle_name": "A. R.",
        "authorized_official_title_or_position": "OWNER/SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "919-451-8729",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.ED., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "8844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205065448",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knightdale, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.

Verify at the official NPI Registry.