Active NPI
Jordan Differding, MS, CCC-SLP
- Speech-Language Pathologist
- Baltimore, MD
National Provider Identifier
1194371195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 08109
- Practice address
- 6569 N Charles St Ste 402
Baltimore, MD 21204-5814 - Phone
- (443) 849-2087
- Fax
- (443) 849-8534
- NPI assigned
- Aug 15, 2019
- Sex
- Male
- 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 | 08109 | MD | Primary |
Addresses
Primary practice location
6569 N Charles St Ste 402
Baltimore, MD 21204-5814
Mailing address
6569 N Charles St Ste 402
Baltimore, MD 21204-5814
Phone (443) 849-2087
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08109 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565827200000",
"number": "1194371195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6569 N CHARLES ST STE 402",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212045814",
"telephone_number": "443-849-2087",
"fax_number": "443-849-8534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6569 N CHARLES ST STE 402",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212045814",
"telephone_number": "443-849-2087",
"fax_number": "443-849-8534"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIFFERDING",
"first_name": "JORDAN",
"credential": "MS, CCC-SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-15",
"last_updated": "2019-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": "08109",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
- Gregory Bruce Diette, M.D.
- Edith Dietz, MD
- Harry C Dietz III, M.D.
- Alarica Nicole Dietzen
- Christine O Diffenderffer, CRNP
- Karen Brownlie Difilippo, CRNP
- Dig-in-to Change/Knowledge, Power and Wisdom, LLC
- Dig-in-to Change/Knowledge, Power and Wisdom, LLC
- Dig-in-to Change/Knowledge, Power and Wisdom, LLC
- Dig-in-to Change/Knowledge, Power and Wisdom, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.