Individual provider Active NPI

Debra L Penland, MSP;CCC-SLP

  • Speech-Language Assistant
  • Goose Creek, SC
National Provider Identifier
1033623897
Registry record updated Nov 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
316 Issued in SC
Practice address
131 Charles B Gibson Blvd
Goose Creek, SC 29445-4559
Phone
(843) 797-2620
NPI assigned
Nov 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 316 SC Primary

Addresses

Primary practice location

131 Charles B Gibson Blvd
Goose Creek, SC 29445-4559

Mailing address

229 E Main St
Moncks Corner, SC 29461-3767

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

Practice roles

OrganizationSpecialtyStatusNew patients
Berkeley County School District Past Accepting new patients

Organizations & group practices 1

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": "1512000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512000000000",
    "number": "1033623897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 E MAIN ST",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 CHARLES B GIBSON BLVD",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294454559",
            "telephone_number": "843-797-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENLAND",
        "first_name": "DEBRA",
        "middle_name": "L",
        "name_prefix": "Miss",
        "credential": "MSP;CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-30",
        "last_updated": "2017-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "SC",
            "license": "316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goose Creek, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2017; 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.