NPIMap

Organization Active NPI

Speech-Language Pathology Services, Inc.

  • Speech-Language Pathologist
  • Whiteville, NC
National Provider Identifier
1821148180
Registry record updated Jun 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3904 Issued in NC
Legal business name
SPEECH-LANGUAGE PATHOLOGY SERVICES, INC.
Practice address
109 E Wyche St
Whiteville, NC 28472-3429
Phone
(910) 914-6100
Fax
(910) 914-6095
NPI assigned
Jan 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2014

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

Authorized official

Name
Elizabeth C Brown, MSP,CCC-SLP
Title
President
Phone
(910) 914-6100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 3904 NC Primary

Addresses

Primary practice location

109 E Wyche St
Whiteville, NC 28472-3429

Mailing address

109 East Wyche Street
PO Box 762
Whiteville, NC 28472-0762
Phone (910) 914-6100

Other identifiers 2

IdentifierTypeStateIssuer
7200561MedicaidNC
7470724MedicaidNC

National Provider Directory

National Provider Directory

Locations

109 E Wyche St
Whiteville, NC 28472
Phone (910) 642-8700

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404086400000",
    "number": "1821148180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 EAST WYCHE STREET",
            "address_2": "PO BOX 762",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284720762",
            "telephone_number": "910-914-6100",
            "fax_number": "910-914-6095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 E WYCHE ST",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284723429",
            "telephone_number": "910-914-6100",
            "fax_number": "910-914-6095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEECH-LANGUAGE PATHOLOGY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2014-06-30",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-914-6100",
        "authorized_official_credential": "MSP,CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "3904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7200561",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7470724",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2014; 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.