Edpath Specialized Learning Services, LLC

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

WSCDSA-0716 Issued in NC

Legal business name

EDPATH SPECIALIZED LEARNING SERVICES, LLC

Practice address

180 Thacker Rd
Rural Hall, NC 27045-9629

Phone

(336) 705-1763

NPI assigned

Jul 15, 2016

Organization subpart

No

Name

Sheryl GraceNPI 1386026318

Title

Owner-Director

Phone

(336) 705-1763

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

• Sheryl Grace, PHD

  • Early Intervention Provider Agency
  • Rural Hall, NC
  • NPI 1386026318
  NPD Authorized official

Interoperability endpoints

• Direct secure messaging: edpath@org12.direct.charmhealth.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 24, 2021.

{
    "created_epoch": "1468540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637712000000",
    "number": "1891148730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 THACKER RD",
            "city": "RURAL HALL",
            "state": "NC",
            "postal_code": "270459629",
            "telephone_number": "336-705-1763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 THACKER RD",
            "city": "RURAL HALL",
            "state": "NC",
            "postal_code": "270459629",
            "telephone_number": "336-705-1763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDPATH SPECIALIZED LEARNING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-15",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A",
        "authorized_official_last_name": "GRACE",
        "authorized_official_first_name": "SHERYL",
        "authorized_official_title_or_position": "OWNER-DIRECTOR",
        "authorized_official_telephone_number": "336-705-1763"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NC",
            "license": "WSCDSA-0716",
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edpath@org12.direct.charmhealth.com",
            "affiliation": "N",
            "address_1": "180 Thacker Rd",
            "city": "Rural Hall",
            "state": "NC",
            "country_code": "US",
            "postal_code": "270459629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Divine Nest
• Divine Nest
• Dr Susan Ziglar
• Delvondria Daiyunte Dubose, MA, LCAS, CCS, LPC-A
• Eckerd Corporation
• Cathy Jo Fanning, DO
• Denise Fetters, LCMHC
• Kristen Gish, RN, IBCLC
• Sheryl Grace, PHD
• Tarsha M. Hall, MSW, LCSW

• All providers in Rural Hall, NC
• Early Intervention Provider Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2021; 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.