Individual provider Active NPI

Nancy Brandenburger, SLP-CCC

  • Speech-Language Pathologist
  • Chester, MD
National Provider Identifier
1053540211
Registry record updated Jul 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
01400 Issued in MD
Practice address
1630 Main St
Suite 110
Chester, MD 21619-2791
Phone
(410) 604-2982
NPI assigned
Jul 9, 2009
Last updated
Jul 9, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2009

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 01400 MD Primary

Addresses

Primary practice location

1630 Main St
Suite 110
Chester, MD 21619-2791

Mailing address

1502 Queen Anne Dr
Chester, MD 21619-2826
Phone (410) 643-4906

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

NPI Registry JSON

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

{
    "created_epoch": "1247097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247097600000",
    "number": "1053540211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 QUEEN ANNE DR",
            "city": "CHESTER",
            "state": "MD",
            "postal_code": "216192826",
            "telephone_number": "410-643-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 MAIN ST",
            "address_2": "SUITE 110",
            "city": "CHESTER",
            "state": "MD",
            "postal_code": "216192791",
            "telephone_number": "410-604-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDENBURGER",
        "first_name": "NANCY",
        "name_prefix": "Mrs.",
        "credential": "SLP-CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-09",
        "last_updated": "2009-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "01400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2009; 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.