NPIMap

Organization Active NPI

Pender Pediatric Therapy, PC

  • Speech-Language Pathologist
  • Burgaw, NC
National Provider Identifier
1881136851
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
PENDER PEDIATRIC THERAPY, PC
Practice address
101 East Satchwell Street
Burgaw, NC 28425
Phone
(910) 300-6150
Fax
(844) 803-6048
NPI assigned
Nov 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Authorized official

Name
Courtney L Gibbs, MS, CCC-SLPNPI 1407117682
Title
President
Phone
(910) 300-6150

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

101 East Satchwell Street
Burgaw, NC 28425

Mailing address

PO Box 662
Burgaw, NC 28425-0662
Phone (910) 663-5450

National Provider Directory

National Provider Directory

Locations

101 E Satchwell St
Burgaw, NC 28425
Phone (336) 317-4785

44 Shuckin St
Unit 202
Hampstead, NC 28443
Phone (910) 300-6150

5713 Oleander Dr Ste 209
Wilmington, NC 28403

5717 Oleander Dr Ste 209
Wilmington, NC 28403

5711 Oleander Dr Ste 209
Wilmington, NC 28403

5712 Oleander Dr
Ste 209
Wilmington, NC 28403

5715 Oleander Dr Ste 209
Wilmington, NC 28403

5710 Oleander Dr
Ste 209
Wilmington, NC 28403
Phone (910) 300-6150

Practitioners & affiliated clinicians

Practitioners 9

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": "1478563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698278400000",
    "number": "1881136851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 662",
            "city": "BURGAW",
            "state": "NC",
            "postal_code": "284250662",
            "telephone_number": "910-663-5450",
            "fax_number": "844-803-6048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 EAST SATCHWELL STREET",
            "city": "BURGAW",
            "state": "NC",
            "postal_code": "28425",
            "telephone_number": "910-300-6150",
            "fax_number": "844-803-6048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENDER PEDIATRIC THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-08",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-25",
        "status": "A",
        "authorized_official_last_name": "GIBBS",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-300-6150",
        "authorized_official_credential": "MS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burgaw, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.