Tywanda J Eley

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

05149 Issued in MD

Practice address

1401 Dennis Ave
Silver Spring, MD 20902-3827

Phone

(240) 286-6531

NPI assigned

Jul 19, 2007

Reactivated

Jul 24, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tywanda Eley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: tywanda.eley.p1@direct.mcg-hhs.nextgenshare.com
• Direct secure messaging: tywanda.eley.p3@direct.mcg-hhs.nextgenshare.com

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1194925065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 DENNIS AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209023827",
            "telephone_number": "240-286-6531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 DENNIS AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209023827",
            "telephone_number": "240-286-6531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELEY",
        "first_name": "TYWANDA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-19",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "deactivation_date": "2010-07-28",
        "reactivation_date": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "05149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TYWANDA",
            "last_name": "ELEY",
            "credential": "SIMPSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Kate Elie, LCSW-C
• Eliezer Trybuch DPM,LLC

• Speech-Language Pathologist in Silver Spring, MD
• Providers in Silver Spring, MD by specialty
• Speech-Language Pathologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.

Verify at the official NPI Registry.