Individual provider Active NPI

Eileen Masterson

  • Speech-Language Pathologist
  • Charlotte, NC
National Provider Identifier
1811235815
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
15489 Issued in NC
Practice address
15133 Lake Ridge Rd
Charlotte, NC 28278-6303
Phone
(704) 249-6352
NPI assigned
Jan 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 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 15489 NC Primary

Addresses

Primary practice location

15133 Lake Ridge Rd
Charlotte, NC 28278-6303

Mailing address

15133 Lake Ridge Rd
Charlotte, NC 28278-6303
Phone (704) 249-6352

Other practice location 1

4421 Stuart Andrew Blvd
Charlotte, NC 28217-1589
Phone (980) 343-6960

Other identifiers 2

IdentifierTypeStateIssuer
6112MedicaidNC
6112MedicaidSC

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

State licenses

LicenseStateTypeSpecialty
15489NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1359072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1811235815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15133 LAKE RIDGE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282786303",
            "telephone_number": "704-249-6352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15133 LAKE RIDGE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282786303",
            "telephone_number": "704-249-6352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4421 Stuart Andrew Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282171589",
            "country_code": "US",
            "telephone_number": "980-343-6960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASTERSON",
        "first_name": "EILEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-25",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "15489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6112",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6112",
            "state": "SC"
        }
    ],
    "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 May 28, 2026; 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.