Spark Speech PLLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

SPARK SPEECH PLLC

Practice address

149 Scofield Rd
Charlotte, NC 28209-3625

Phone

(980) 241-3066

NPI assigned

Oct 18, 2024

Organization subpart

No

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

Authorized official

Name

Addyson BrothertonNPI 1568945418

Title

President

Phone

(980) 241-3066

Specialties & licenses 1

Addresses

Practitioners 1

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

• Addyson Pound Brotherton, MSP, CCC-SLP

  • Speech-Language Pathologist
  • Charlotte, NC
  • NPI 1568945418
  NPD Authorized official

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

{
    "created_epoch": "1729209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729209600000",
    "number": "1841011236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 SCOFIELD RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093625",
            "telephone_number": "980-241-3066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 SCOFIELD RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093625",
            "telephone_number": "980-241-3066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARK SPEECH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-18",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A",
        "authorized_official_last_name": "BROTHERTON",
        "authorized_official_first_name": "ADDYSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "980-241-3066"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lacey Spangler, RN
• Matthew Wynne Spangler, MD
• Larrvetta Spann
• Sparc Network
• Spark Relationship and Intimacy Counseling
• Amy Sparks, R.D.
• Edwin Wayne Sparks Jr., MD
• Kayla Sparks
• Penny Sparks, FNP
• Matthew Sparling, M.S.ED

• Speech-Language Pathologist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Speech-Language Pathologist in North Carolina

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