Individual provider Active NPI

Kiersten Anastasha Gladys Brown

  • Speech-Language Pathologist
  • Bel Air, MD
National Provider Identifier
1003433897
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
02061L Issued in MD
Practice address
100 Thomas Run Rd
Bel Air, MD 21015-1616
Phone
(410) 638-3810
NPI assigned
Jun 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 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 02061L MD Primary

Addresses

Primary practice location

100 Thomas Run Rd
Bel Air, MD 21015-1616

Mailing address

102 S Hickory Ave
Bel Air, MD 21014-3731
Phone (410) 838-7300

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
02061LMDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Harford County Infants &Toddlers Program PastSince Jul 5, 2020 Accepting new patients
Harford County Public Schools PastSince Jul 5, 2020 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1003433897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 S HICKORY AVE",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210143731",
            "telephone_number": "410-838-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 THOMAS RUN RD",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210151616",
            "telephone_number": "410-638-3810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KIERSTEN",
        "middle_name": "ANASTASHA GLADYS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-29",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "02061L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.