Active NPI
Hannelyn Perez
- Speech-Language Pathologist
- Clarksburg, MD
National Provider Identifier
1073393757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 10865
- Practice address
- 12520 Blue Sky Dr
Clarksburg, MD 20871-4512 - Phone
- (240) 406-1670
- NPI assigned
- Oct 2, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 10865 | MD | Primary |
Addresses
Primary practice location
12520 Blue Sky Dr
Clarksburg, MD 20871-4512
Mailing address
1309 5TH Ave Apt 27C
New York, NY 10029-3127
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10865 | MD | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696204800000",
"number": "1073393757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1309 5TH AVE APT 27C",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100293127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12520 BLUE SKY DR",
"city": "CLARKSBURG",
"state": "MD",
"postal_code": "208714512",
"telephone_number": "240-406-1670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "HANNELYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-02",
"last_updated": "2023-10-02",
"certification_date": "2023-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": "10865",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarksburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.