Active NPI
Sandra Ellen Fallon, MS-CCC-SLP
- Speech-Language Pathologist
- Baltimore, MD
National Provider Identifier
1265602908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 05162
- Practice address
- 7205 Rutherford Rd
Baltimore, MD 21244-2711 - Phone
- (443) 780-1417
- NPI assigned
- Mar 10, 2008
- 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 | 05162 | MD | Primary |
Addresses
Primary practice location
7205 Rutherford Rd
Baltimore, MD 21244-2711
Mailing address
7205 Rutherford Rd
Baltimore, MD 21244-2711
Phone (443) 780-1417
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05162 | MD | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| National Center on Institution and Alternatives | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Student in an Organized Health Care Education/Training Program
- Windsor Mill, MD
- NPI 1063544898
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205107200000",
"number": "1265602908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7205 RUTHERFORD RD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212442711",
"telephone_number": "443-780-1417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7205 RUTHERFORD RD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212442711",
"telephone_number": "443-780-1417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FALLON",
"first_name": "SANDRA",
"middle_name": "ELLEN",
"name_prefix": "Miss",
"credential": "MS-CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-10",
"last_updated": "2008-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": "05162",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.