Kelly Burgdorf, AU.D.
Individual provider Active NPI Audiologist · Kensington, MD
NPI 1114385671 · NPPES record last updated May 28, 2021
Key facts
- NPI
- 1114385671
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist 231H00000X
- License
- 01351 (MD)
- Practice address
- 10810 Connecticut Ave
Building 2
Kensington, MD 20895-2138 - Phone
- (301) 929-7168
- NPI assigned
- Jan 29, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AUD000146 | DC | MD | Audiologist |
| 01351 | MD | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | AUD000146 | DC | |
| Audiologist | 231H00000X | 01351 | MD | Yes |
Addresses
Primary practice location
10810 Connecticut Ave
Building 2
Kensington, MD 20895-2138
Mailing address
10810 Connecticut Ave
Building 2
Kensington, MD 20895-2138
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways | Health Information Exchange (HIE) |
Other providers in Kensington, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.