Carolina Speech Source, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

CAROLINA SPEECH SOURCE, LLC

Practice address

858 2ND St NE Ste 101
Hickory, NC 28601-3878

Phone

(828) 322-7826

NPI assigned

Dec 27, 2005

Last updated

Feb 18, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Katelyn Donovan

Title

Owner

Phone

(828) 322-7826

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Luis Felipe Freile, DPT

  • Physical Therapist
  • Hickory, NC
  • NPI 1598380214
  NPD (past)
• Amelia Seaver Kellam, CCC-SLP

  • Speech-Language Pathologist
  • Boone, NC
  • NPI 1104435510
  NPD (past)
• Bailey Gragg Mitchell, OTR/L

  • Occupational Therapist
  • Hickory, NC
  • NPI 1639763907
  NPD (past)
• Mary Weddington Poetker, PT

  • Physical Therapist
  • Conover, NC
  • NPI 1235485160
  NPD (past)
• Brittany Lyalls Self, OT

  • Occupational Therapist
  • Lenoir, NC
  • NPI 1205284486
  NPD (past)

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581984000000",
    "number": "1881671394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "858 2ND ST NE STE 101",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286013878",
            "telephone_number": "828-322-7826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "858 2ND ST NE STE 101",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286013878",
            "telephone_number": "828-322-7826"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "509 E Parker Rd",
            "address_purpose": "LOCATION",
            "city": "Morganton",
            "state": "NC",
            "postal_code": "286555104",
            "country_code": "US",
            "telephone_number": "828-322-7826",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1880 N Center St",
            "address_purpose": "LOCATION",
            "city": "Hickory",
            "state": "NC",
            "postal_code": "286011853",
            "country_code": "US",
            "telephone_number": "828-322-7826",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1225 Commerce St SW",
            "address_purpose": "LOCATION",
            "city": "Conover",
            "state": "NC",
            "postal_code": "286138355",
            "country_code": "US",
            "telephone_number": "283-227-8268",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 10th St NW",
            "address_purpose": "LOCATION",
            "city": "Conover",
            "state": "NC",
            "postal_code": "286132419",
            "country_code": "US",
            "telephone_number": "828-322-7826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CAROLINA SPEECH SOURCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-27",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A",
        "authorized_official_last_name": "DONOVAN",
        "authorized_official_first_name": "KATELYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "828-322-7826"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7211073",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Carolina Treatment Associates
• Carolinas Medical Center (Women's Institute - Hickory)

• Speech-Language Pathologist in Hickory, NC
• Providers in Hickory, 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 Feb 18, 2020; 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.