Individual provider Active NPI

Bianca Patrice Boston, M.A. CCC-SLP

  • Speech-Language Pathologist
  • Charlotte, NC
National Provider Identifier
1790134872
Registry record updated Feb 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
11801 Issued in NC
Practice address
13739 Steele Creek Rd Unit 103
Charlotte, NC 28273-7139
Phone
(704) 980-8646
NPI assigned
Jun 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2022

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 11801 NC Primary

Addresses

Primary practice location

13739 Steele Creek Rd Unit 103
Charlotte, NC 28273-7139

Mailing address

5714 Quercus Cove CT Apt 208
Charlotte, NC 28217-0334
Phone (704) 980-8646

Other practice location 1

5714 Quercus Cove Ct Apt 208
Charlotte, NC 28217-0334
Phone (704) 493-8817

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

LicenseStateTypeSpecialty
11801NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bee Empowered LLC Speech-Language Pathologist CurrentSince Feb 24, 2022 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1790134872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5714 QUERCUS COVE CT APT 208",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282170334",
            "telephone_number": "704-980-8646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13739 STEELE CREEK RD UNIT 103",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282737139",
            "telephone_number": "704-980-8646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5714 Quercus Cove Ct Apt 208",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282170334",
            "country_code": "US",
            "telephone_number": "704-493-8817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSTON",
        "first_name": "BIANCA",
        "middle_name": "PATRICE",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-08",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "11801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; 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.