Anna Peterson, MS, CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

04722 Issued in MD

Practice address

10435 Downsville Pike
Hagerstown, MD 21740-1732

Phone

(301) 766-8200

NPI assigned

Oct 25, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1245314020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18923 CROFTON RD",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217422733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10435 DOWNSVILLE PIKE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217401732",
            "telephone_number": "301-766-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11110 Medical Campus Rd",
            "address_2": "201",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217426700",
            "country_code": "US",
            "telephone_number": "301-714-4025",
            "fax_number": "301-714-4026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ANNA",
        "credential": "MS, CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "04722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245314020",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Hagerstown, MD
• Providers in Hagerstown, 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 Feb 28, 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.

Verify at the official NPI Registry.