Active NPI
Damien J Macon, SLP
- Speech-Language Pathologist
- Columbia, MD
National Provider Identifier
1275269375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 02397L
- Practice address
- 10320 Swift Stream PL Apt 203
Columbia, MD 21044-4894 - Phone
- (813) 244-7386
- NPI assigned
- Jul 29, 2022
- Sex
- Male
- 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 | 02397L | MD | Primary |
Addresses
Primary practice location
10320 Swift Stream PL Apt 203
Columbia, MD 21044-4894
Mailing address
10045 Baltimore National Pike Unit A7 #679
Ellicott City, MD 21042
Phone (813) 244-7386
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 |
|---|---|---|---|
| 02397L | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659052800000",
"number": "1275269375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10045 BALTIMORE NATIONAL PIKE UNIT A7 #679",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "21042",
"telephone_number": "813-244-7386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10320 SWIFT STREAM PL APT 203",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210444894",
"telephone_number": "813-244-7386"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACON",
"first_name": "DAMIEN",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-29",
"last_updated": "2022-07-29",
"certification_date": "2022-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": "02397L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.