Individual provider Active NPI

Karen Singletary-Fuller, MA CCC-SLP

  • Speech-Language Pathologist
  • Fairfax, VA
National Provider Identifier
1114067626
Registry record updated May 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202003160 Issued in VA
Practice address
4211 Ridge Top Rd Apt 3626
Fairfax, VA 22030-1111
Phone
(703) 298-3421
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2011

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7112 NC
Speech-Language Pathologist 235Z00000X 2293 SC
Speech-Language Pathologist 235Z00000X 2202003160 VA Primary
Speech-Language Pathologist 235Z00000X SLP007149 GA

Addresses

Primary practice location

4211 Ridge Top Rd Apt 3626
Fairfax, VA 22030-1111

Mailing address

4211 Ridge Top Rd Apt 3626
Fairfax, VA 22030-1111
Phone (703) 298-3421

Other identifiers 1

IdentifierTypeStateIssuer
7412535MedicaidNC

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
7112NCMDProfessional Counselor
2293SCMDPhysical Therapist
SLP007149GAMDSpeech-Language Pathologist
2202003160VAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305763200000",
    "number": "1114067626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 RIDGE TOP RD APT 3626",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220301111",
            "telephone_number": "703-298-3421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 RIDGE TOP RD APT 3626",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220301111",
            "telephone_number": "703-298-3421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINGLETARY-FULLER",
        "first_name": "KAREN",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2011-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "7112",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "2293",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202003160",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP007149",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7412535",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; 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.