Individual provider Active NPI

Kristen Boretti Williams, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Cary, NC
National Provider Identifier
1780288423
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
30002216 Issued in NC
Practice address
300 Kildaire Woods Dr
Cary, NC 27511-5500
Phone
(919) 390-1906
NPI assigned
Nov 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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 30002216 NC Primary

Addresses

Primary practice location

300 Kildaire Woods Dr
Cary, NC 27511-5500

Mailing address

PO Box 603949
Charlotte, NC 28260-3949
Phone (877) 498-4490

Other practice location 1

10000 Cambridge Village Loop
Apex, NC 27502-7707
Phone (919) 350-1508

Other identifiers 2

IdentifierTypeStateIssuer
14335156OtherASHA
13712OtherNCNCBOESLPA

Other names 1

  • Kristen Nicole Boretti Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251009004550 NC Practitioner - Qualified Speech Language Pathologist 8224418827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Charlotte, NC 28260

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30002216NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group, LLC Current Accepting new patients
Wakemed Specialists Group LLC CurrentSince Jul 1, 2025 Accepting new patients
Wakemed Specialists Group, LLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

10000 Cambridge Village Loop
Apex, NC 27502
Phone (919) 363-2080

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

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": "1606089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1780288423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603949",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603949",
            "telephone_number": "877-498-4490",
            "fax_number": "919-350-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 KILDAIRE WOODS DR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275115500",
            "telephone_number": "919-390-1906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10000 Cambridge Village Loop",
            "address_purpose": "LOCATION",
            "city": "Apex",
            "state": "NC",
            "postal_code": "275027707",
            "country_code": "US",
            "telephone_number": "919-350-1508",
            "fax_number": "919-350-1475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KRISTEN",
        "middle_name": "BORETTI",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-23",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30002216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA",
            "identifier": "14335156",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCBOESLPA",
            "identifier": "13712",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "BORETTI",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; 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.