Individual provider Active NPI

Shannon Marie Fischer

  • Speech-Language Pathologist
  • Gaithersburg, MD
National Provider Identifier
1003413949
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
09262 Issued in MD
Practice address
101 W Deer Park Rd
Gaithersburg, MD 20877-1850
Phone
(301) 284-4150
NPI assigned
Oct 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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 09262 MD Primary

Addresses

Primary practice location

101 W Deer Park Rd
Gaithersburg, MD 20877-1850

Mailing address

850 Hungerford Dr
Rockville, MD 20850-1718
Phone (240) 740-5500

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

LicenseStateTypeSpecialty
09262MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Montgomery County Maryland Government CurrentSince May 12, 2024 Accepting new patients
Montgomery County Maryland Government CurrentSince Oct 1, 2023 Accepting new patients

Locations

101 W Deer Park Rd
Gaithersburg, MD 20877
Phone (301) 284-4150

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1003413949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 HUNGERFORD DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208501718",
            "telephone_number": "240-740-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W DEER PARK RD",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771850",
            "telephone_number": "301-284-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHER",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-05",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "09262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; 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.