Individual provider Active NPI

Eliza A Stayton, SLP

  • Speech-Language Pathologist
  • Salisbury, MD
National Provider Identifier
1205398773
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
08576 Issued in MD
Practice address
224 Phillip Morris Dr Ste 202
Salisbury, MD 21804-2000
Phone
(302) 217-3120
NPI assigned
Apr 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 08576 MD Primary

Addresses

Primary practice location

224 Phillip Morris Dr Ste 202
Salisbury, MD 21804-2000

Mailing address

3819 Rumsey Dr
Trappe, MD 21673-1722
Phone (443) 504-9629

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190606001450 DC Practitioner - Qualified Speech Language Pathologist 5395078315 Reassigns benefits to 1 organization
I20190606001587 MD Practitioner - Qualified Speech Language Pathologist 5395078315 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08576MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
LHMG Physical Therapy, LLC CurrentSince Apr 15, 2019 Accepting new patients
LHMG Physical Therapy, LLC CurrentSince Aug 9, 2017 Accepting new patients
LHMG Physical Therapy, LLC CurrentSince Aug 9, 2017 Accepting new patients

Locations

201 Defense Hwy
Ste 100
Annapolis, MD 21401
Phone (443) 481-6549

4175 N Hanson Ct
Ste 301
Bowie, MD 20716
Phone (301) 805-0190

6836 Race Track Rd
Bowie, MD 20715
Phone (301) 805-7004

2000 Medical Pkwy
Cpe St Claire, MD 21401
Phone (443) 481-3400

28438 Marlboro Ave
Easton, MD 21601
Phone (410) 820-7270

8638 Veterans Hwy
Fl 1
Millersville, MD 21108
Phone (410) 729-4508

1106 Annapolis Rd
Ste 120
Odenton, MD 21113
Phone (410) 674-1650

8109 Ritchie Hwy
Ste 600
Pasadena, MD 21122
Phone (410) 553-3515

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1205398773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3819 RUMSEY DR",
            "city": "TRAPPE",
            "state": "MD",
            "postal_code": "216731722",
            "telephone_number": "443-504-9629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 PHILLIP MORRIS DR STE 202",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218042000",
            "telephone_number": "302-217-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAYTON",
        "first_name": "ELIZA",
        "middle_name": "A",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-03",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "08576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.