Individual provider Active NPI

Deniece Maragrita' Payne, MS-SLP, MED

  • Speech-Language Pathologist
  • Fredericksburg, VA
National Provider Identifier
1003052523
Registry record updated May 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
10105 S Fulton Dr
Fredericksburg, VA 22408-0260
Phone
(571) 330-8120
Fax
(877) 771-3419
NPI assigned
Jan 6, 2009
Last updated
May 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech/Language/Hearing Specialist/TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 235500000X VA
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X VA Primary

Addresses

Primary practice location

10105 S Fulton Dr
Fredericksburg, VA 22408-0260

Mailing address

10105 S Fulton Dr
Fredericksburg, VA 22408-0260
Phone (571) 330-8120

Other practice location 1

10851 Tidewater Trl
#103
Fredericksburg, VA 22408-2048
Phone (571) 330-8120

Other identifiers 1

IdentifierTypeStateIssuer
1073788931MedicaidVA

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)
Enrolled
Credentials
Master of Education

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.

NPI Registry JSON

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

{
    "created_epoch": "1231200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558224000000",
    "number": "1003052523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10105 S FULTON DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224080260",
            "telephone_number": "571-330-8120",
            "fax_number": "877-771-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10105 S FULTON DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224080260",
            "telephone_number": "571-330-8120",
            "fax_number": "877-771-3419"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10851 Tidewater Trl",
            "address_2": "#103",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224082048",
            "country_code": "US",
            "telephone_number": "571-330-8120",
            "fax_number": "877-771-3419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "DENIECE",
        "middle_name": "MARAGRITA'",
        "name_prefix": "Ms.",
        "credential": "MS-SLP, MED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-06",
        "last_updated": "2019-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073788931",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.