NPIMap

Organization Active NPI

Kidspeak Speech and Language Services, Inc.

  • Speech-Language Pathologist
  • Charlotte, NC
National Provider Identifier
1831226745
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4765 Issued in NC
Legal business name
KIDSPEAK SPEECH AND LANGUAGE SERVICES, INC.
Practice address
6911 Shannon Willow Road
Suite 700
Charlotte, NC 28226
Phone
(704) 540-3777
Fax
(704) 540-1443
NPI assigned
Feb 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Authorized official

Name
Mr. Gordy Rogers, M.S., CCC-SLP
Title
Owner
Phone
(917) 628-7525

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 4765 NC Primary

Addresses

Primary practice location

6911 Shannon Willow Road
Suite 700
Charlotte, NC 28226

Mailing address

6911 Shannon Willow Road
Suite 700
Charlotte, NC 28226
Phone (704) 540-3777

Other identifiers 2

IdentifierTypeStateIssuer
12889OtherNCBLUECROSSBLUESHIELD
7648723OtherNCAETNA

National Provider Directory

National Provider Directory

Locations

6911 Shannon Willow Rd
Ste 700
Charlotte, NC 28226
Phone (704) 540-3777

Practitioners & affiliated clinicians

Practitioners 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708387200000",
    "number": "1831226745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6911 SHANNON WILLOW ROAD",
            "address_2": "SUITE 700",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28226",
            "telephone_number": "704-540-3777",
            "fax_number": "704-540-1443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6911 SHANNON WILLOW ROAD",
            "address_2": "SUITE 700",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28226",
            "telephone_number": "704-540-3777",
            "fax_number": "704-540-1443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDSPEAK SPEECH AND LANGUAGE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2024-02-20",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "GORDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-628-7525",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.S., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "4765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "12889",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7648723",
            "state": "NC"
        }
    ],
    "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 20, 2024; 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.