Individual provider Active NPI

Olivia Gabrielle Longo Rachel, M.S CF-SLP

  • Speech-Language Pathologist
  • Frederick, MD
National Provider Identifier
1326732421
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
8411 Broadband Dr
Unit D
Frederick, MD 21701
Phone
(301) 682-4803
NPI assigned
Jun 5, 2023
Last updated
Jun 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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 MD Primary

Addresses

Primary practice location

8411 Broadband Dr
Unit D
Frederick, MD 21701

Mailing address

11016 Haney Ter
Damascus, MD 20872-1759
Phone (443) 686-1660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240606004017 MD Practitioner - Qualified Speech Language Pathologist 9739621657 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Baltimore Medical Center, Inc. CurrentSince May 28, 2024 Accepting new patients
Greater Baltimore Medical Center, Inc. CurrentSince May 28, 2024 Accepting new patients
Greater Baltimore Medical Center, Inc Current Accepting new patients

Locations

6569 N Charles St
Ste 307
Towson, MD 21204
Phone (443) 849-2767

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1326732421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11016 HANEY TER",
            "city": "DAMASCUS",
            "state": "MD",
            "postal_code": "208721759",
            "telephone_number": "443-686-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8411 BROADBAND DR",
            "address_2": "UNIT D",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "21701",
            "telephone_number": "301-682-4803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACHEL",
        "first_name": "OLIVIA",
        "middle_name": "GABRIELLE LONGO",
        "credential": "M.S CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.