Active NPI
Mary Reis, CCC-SLP
- Speech-Language Pathologist
- Germantown, MD
National Provider Identifier
1245709195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 03838
- Practice address
- 11690 Neelsville Church Rd
Germantown, MD 20876-4127 - Phone
- (301) 353-0972
- Fax
- (301) 601-0386
- NPI assigned
- Nov 21, 2018
- Sex
- Female
- 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 | 03838 | MD | Primary |
Addresses
Primary practice location
11690 Neelsville Church Rd
Germantown, MD 20876-4127
Mailing address
11690 Neelsville Church Rd
Germantown, MD 20876-4127
Phone (301) 353-0972
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03838 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542758400000",
"number": "1245709195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11690 NEELSVILLE CHURCH RD",
"city": "GERMANTOWN",
"state": "MD",
"postal_code": "208764127",
"telephone_number": "301-353-0972",
"fax_number": "301-601-0386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11690 NEELSVILLE CHURCH RD",
"city": "GERMANTOWN",
"state": "MD",
"postal_code": "208764127",
"telephone_number": "301-353-0972",
"fax_number": "301-601-0386"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REIS",
"first_name": "MARY",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-21",
"last_updated": "2018-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": "03838",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Germantown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.