Organization Active NPI

Speech and Language Rehabilitation Services, Inc.

Speech-Language Pathologist
Clinton, NC

National Provider Identifier

1891858692

Registry record updated Oct 19, 2011

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
Practitioners & affiliated clinicians
NPI Registry JSON
Other providers in Clinton, NC
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Speech-Language PathologistTaxonomy code 235Z00000X
License: 932 Issued in NC
Legal business name: SPEECH AND LANGUAGE REHABILITATION SERVICES, INC.
Practice address: 600 Sunset Ave
Clinton, NC 28328-3946
Phone: (910) 299-0700
Fax: (910) 299-0800
NPI assigned: Dec 19, 2006
Organization subpart: No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Authorized official

Name: Mrs. Nellie Herring Hudson, MS, CCC,SLPNPI 1811032055
Title: Speech Pathologist,President
Phone: (910) 299-0700

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 15

Specialty (taxonomy)	Code	License	State	Primary
Speech-Language AssistantGroup: 193200000X MULTI-SPECIALTY GROUP	2355S0801X	SLP-A 0036	NC
Speech-Language AssistantGroup: 193200000X MULTI-SPECIALTY GROUP	2355S0801X	SLP-A 0064	NC
Speech-Language AssistantGroup: 193200000X MULTI-SPECIALTY GROUP	2355S0801X	SLP-A 0021	NC
Speech-Language AssistantGroup: 193200000X MULTI-SPECIALTY GROUP	2355S0801X	SLP-A 0103	NC
Speech-Language AssistantGroup: 193200000X MULTI-SPECIALTY GROUP	2355S0801X	SLP-A 0058	NC
Speech-Language AssistantGroup: 193200000X MULTI-SPECIALTY GROUP	2355S0801X	SLP-A 0168	NC
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP	235Z00000X	932	NC	Primary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP	235Z00000X	2717	NC
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP	235Z00000X	6808	NC
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP	235Z00000X	6207	NC
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP	235Z00000X	7693	NC
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP	235Z00000X	7671	NC
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP	235Z00000X	7899	NC
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP	235Z00000X	6950	NC
Community/Behavioral Health Agency	251S00000X

Addresses

Primary practice location

600 Sunset Ave
Clinton, NC 28328-3946

Mailing address

PO Box 1414
Clinton, NC 28329
Phone (910) 299-0700

Other identifiers 12

Identifier	Type	State	Issuer
7412837	Medicaid	NC
7412848	Medicaid	NC
7412838	Medicaid	NC
7413237	Medicaid	NC
7210690	Medicaid	NC
7412156	Medicaid	NC
8300101	Medicaid	NC
7413581	Medicaid	NC
7444344	Medicaid	NC
0166Q	Other	NC	BCBS
7411318	Medicaid	NC
8300101K	Medicaid	NC

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment: Enrolled in NC

Enrollment records 1

Enrollment ID	State	Provider type	PAC ID	Details
O20120510000014	NC	Part B Supplier - Clinic/Group Practice	5698811370	Receives reassigned benefits from 2 practitioners Practice locations: Clinton, NC

National Provider Directory

Locations

600 Sunset Ave
Clinton, NC 28328
Phone (910) 299-0700

207 E Main St
Ste A
Clinton, NC 28328

207A W Main St
Clinton, NC 28328
Phone (910) 299-0700

346 Wagoner Dr
Ste 106
Fayetteville, NC 28303
Phone (910) 864-0179

Practitioners & affiliated clinicians

Practitioners 27

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

Nellie Herring Hudson, MS, CCC,SLP
- Speech-Language Pathologist
- Clinton, NC
- NPI 1811032055
Medicare reassignment NPD Authorized official
Lindsay B Horne, MED, CCC/SLP
- Speech-Language Pathologist
- Clinton, NC
- NPI 1871853176
Medicare reassignment NPD
Lesley Best, MED., CCC/SLP
- Speech-Language Pathologist
- Clinton, NC
- NPI 1851651160
NPD (past)
Alonna Pate Bullard
- Speech-Language Pathologist
- Clinton, NC
- NPI 1275059149
NPD (past)
Chandler Moore Seal Burns
- Speech-Language Pathologist
- Clinton, NC
- NPI 1427805951
NPD (past)
Katie Lynn Butler, OTR/L
- Occupational Therapist
- Clinton, NC
- NPI 1699163733
NPD (past)
Lia Kotsopoulos Ernst, M.ED. CCC-SLP
- Speech-Language Pathologist
- Clinton, NC
- NPI 1720473770
NPD (past)
Kelsey Marie Graber
- Occupational Therapist
- Fayetteville, NC
- NPI 1003663519
NPD (past)
Reagan Taylor Hawkins
- Occupational Therapist
- Clinton, NC
- NPI 1548985450
NPD (past)
Mary Ann Honeycutt
- Speech-Language Assistant
- Clinton, NC
- NPI 1447423033
NPD (past)
Liza Deal Jackson, MPT
- Physical Therapist
- Clinton, NC
- NPI 1194252486
NPD (past)
Sarah Lane, MSCCC/SLP
- Speech-Language Pathologist
- Clinton, NC
- NPI 1720256720
NPD (past)

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318982400000",
    "number": "1891858692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1414",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "28329",
            "telephone_number": "910-299-0700",
            "fax_number": "910-299-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 SUNSET AVE",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283283946",
            "telephone_number": "910-299-0700",
            "fax_number": "910-299-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEECH AND LANGUAGE REHABILITATION SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2011-10-19",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "NELLIE",
        "authorized_official_middle_name": "HERRING",
        "authorized_official_title_or_position": "SPEECH PATHOLOGIST,PRESIDENT",
        "authorized_official_telephone_number": "910-299-0700",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, CCC,SLP"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "NC",
            "license": "SLP-A 0036",
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
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            "primary": false
        },
        {
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        },
        {
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        },
        {
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        {
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        },
        {
            "code": "235Z00000X",
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        {
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        },
        {
            "code": "235Z00000X",
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        {
            "code": "235Z00000X",
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        {
            "code": "235Z00000X",
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        {
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            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
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            "identifier": "7412848",
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            "code": "05",
            "desc": "MEDICAID",
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            "issuer": "BCBS",
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    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, NC

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.