Crystal Ipock, MS, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Beulaville, NC
NPI 1912705443 · NPPES record last updated Mar 3, 2025
Key facts
- NPI
- 1912705443
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 6395 (NC)
- Practice address
- 160 N NC 241 Hwy
Beulaville, NC 28518-8636 - Phone
- (910) 298-2331
- NPI assigned
- Mar 3, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Coastal Speech Therapy Inc
Practice addresses (Care Compare)
124 E Park Dr
Beulaville, NC 28518-6916
Phone (888) 258-6905
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250311002419 | NC | Practitioner - Qualified Speech Language Pathologist | 5496276016 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6395 | SC | MD | Pharmacist |
| 6395 | NC | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Speech Therapy Inc | Speech-Language Pathologist | Current |
Accepting new patients |
Locations
160 N NC 241 Hwy
Beulaville, NC 28518
Phone (888) 258-6905
124 E Park Dr
Beulaville, NC 28518
Phone (888) 258-6905
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 6395 | NC | Yes |
Addresses
Primary practice location
160 N NC 241 Hwy
Beulaville, NC 28518-8636
Mailing address
723 Misty Dr
Kinston, NC 28501-6958
Phone (252) 531-5603
Other providers in Beulaville, NC
- Bryan M Horne
- Heather Byrd Houston
- Owen Wayne Houston
- Brittany Hunter
- Intimate Silhouettes by Fran
- Alice Barton Jones
- Erica H. Jones
- Jennifer Rose Jones
- Kendra K. Jones
- Michael B. Jones
All providers in Beulaville, NC · Speech-Language Pathologist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.