Active NPI
Karissa Dorleus, MS, CCC-SLP
- Speech-Language Pathologist
- Fayetteville, NC
National Provider Identifier
1922358399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 10058
- Practice address
- 1289 Oliver Street
Fayetteville, NC 28304 - Phone
- (910) 483-8331
- NPI assigned
- Sep 13, 2012
- Last updated
- Sep 13, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 10058 | NC | Primary |
Addresses
Primary practice location
1289 Oliver Street
Fayetteville, NC 28304
Mailing address
2401 Robeson Street
2ND Floor
Fayetteville, NC 28305
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10058 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Developmental Therapy | Past | Accepting new patients | |
| Pediatric Developmental Therapy | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Rehabilitation Practitioner
- Fayetteville, NC
- NPI 1710183991
-
- Speech-Language Pathologist
- Fayetteville, NC
- NPI 1730137779
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347494400000",
"number": "1922358399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2401 ROBESON STREET",
"address_2": "2ND FLOOR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "28305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1289 OLIVER STREET",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "28304",
"telephone_number": "910-483-8331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DORLEUS",
"first_name": "KARISSA",
"credential": "MS, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-13",
"last_updated": "2012-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "10058",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.