Active NPI
Judith Kramer
- Speech-Language Pathologist
- Waxhaw, NC
National Provider Identifier
1831218007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2518
- Practice address
- 1308 Iveyridge Dr
Waxhaw, NC 28173-7572 - Phone
- (704) 841-3616
- Fax
- (704) 841-3616
- NPI assigned
- Mar 28, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2518 | NC | Primary |
Addresses
Primary practice location
1308 Iveyridge Dr
Waxhaw, NC 28173-7572
Mailing address
1308 Iveyridge Dr
Waxhaw, NC 28173-7572
Phone (704) 841-3616
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SAN044 | Medicaid | SC | |
| 7412359 | Medicaid | NC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2518 | NC | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184544000000",
"number": "1831218007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1308 IVEYRIDGE DR",
"city": "WAXHAW",
"state": "NC",
"postal_code": "281737572",
"telephone_number": "704-841-3616",
"fax_number": "704-841-3616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1308 IVEYRIDGE DR",
"city": "WAXHAW",
"state": "NC",
"postal_code": "281737572",
"telephone_number": "704-841-3616",
"fax_number": "704-841-3616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRAMER",
"first_name": "JUDITH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-28",
"last_updated": "2007-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "2518",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SAN044",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7412359",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waxhaw, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.