NPIMap

Individual provider Active NPI

Renee Eberlan

  • Speech-Language Pathologist
  • Bethesda, MD
National Provider Identifier
1326670639
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
01925L Issued in MD
Practice address
5272 River Rd Ste 100
Bethesda, MD 20816-1454
Phone
(301) 718-1716
NPI assigned
Feb 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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 01925L MD Primary

Addresses

Primary practice location

5272 River Rd Ste 100
Bethesda, MD 20816-1454

Mailing address

5272 River Rd Ste 300
Bethesda, MD 20816-1438

Other names 1

  • Renee Bonnaffons Former name

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

LicenseStateTypeSpecialty
01925LMDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Beginnings, LLC PastSince Feb 9, 2020 Accepting new patients
Optimal Beginnings, LLC Speech-Language Pathologist PastSince Feb 9, 2020 Accepting new patients

Organizations & group practices 2

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": "1580860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1326670639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5272 RIVER RD STE 300",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208161438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5272 RIVER RD STE 100",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208161454",
            "telephone_number": "301-718-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERLAN",
        "first_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-05",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "01925L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEE",
            "last_name": "BONNAFFONS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.