Active NPI
Emily Louise Widrick
- Speech-Language Pathologist
- Greenville, NC
National Provider Identifier
1972861938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 9921
- Practice address
- 910 Bremerton Dr
Greenville, NC 27858-6548 - Phone
- (252) 916-1029
- Fax
- (252) 355-9218
- NPI assigned
- Apr 27, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 | 9921 | NC | Primary |
Addresses
Primary practice location
910 Bremerton Dr
Greenville, NC 27858-6548
Mailing address
PO Box 2417
Winterville, NC 28590-2417
Phone (252) 916-1029
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9921 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335484800000",
"number": "1972861938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2417",
"city": "WINTERVILLE",
"state": "NC",
"postal_code": "285902417",
"telephone_number": "252-916-1029",
"fax_number": "252-355-9218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "910 BREMERTON DR",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278586548",
"telephone_number": "252-916-1029",
"fax_number": "252-355-9218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIDRICK",
"first_name": "EMILY",
"middle_name": "LOUISE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-04-27",
"last_updated": "2012-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "9921",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.