Individual provider Active NPI

Molly Ortman

  • Speech-Language Pathologist
  • Raleigh, NC
National Provider Identifier
1902319056
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
30000606 Issued in NC
Practice address
200 Park at North Hills St Apt 530
Raleigh, NC 27609-2640
Phone
(410) 703-3598
NPI assigned
Nov 12, 2017
Last updated
Oct 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 30000606 NC Primary

Addresses

Primary practice location

200 Park at North Hills St Apt 530
Raleigh, NC 27609-2640

Mailing address

200 Park at North Hills St Apt 530
Raleigh, NC 27609-2640
Phone (410) 703-3598

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231117001131 NC Practitioner - Qualified Speech Language Pathologist 3072960749 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30000606NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Speech Therapy Inc Speech-Language Pathologist CurrentSince Oct 12, 2023 Accepting new patients

Locations

124 E Park Dr
Beulaville, NC 28518
Phone (888) 258-6905

160 N NC 241 Hwy
Beulaville, NC 28518
Phone (888) 258-6905

447 Venture Dr
Ste D
Smithfield, NC 27577
Phone (888) 258-6905

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1510444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1902319056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PARK AT NORTH HILLS ST APT 530",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276092640",
            "telephone_number": "410-703-3598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PARK AT NORTH HILLS ST APT 530",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276092640",
            "telephone_number": "410-703-3598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTMAN",
        "first_name": "MOLLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-12",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30000606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.