Elizabeth Pettway, MS-CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

04800 Issued in MD

Practice address

613 Hammonds LN
Brooklyn Park, MD 21225-3351

Phone

(410) 350-8514

NPI assigned

Apr 3, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336260553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2499 REVERE CT",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211143251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 HAMMONDS LN",
            "city": "BROOKLYN PARK",
            "state": "MD",
            "postal_code": "212253351",
            "telephone_number": "410-350-8514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTWAY",
        "first_name": "ELIZABETH",
        "credential": "MS-CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "04800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prafullkumar Patel, MD LLC
• Priority Home Care of Maryland
• Project Chesapeake LLC
• Project Chesapeake LLC
• Project Chesapeake, LLC

• Speech-Language Pathologist in Brooklyn Park, MD
• Providers in Brooklyn Park, MD by specialty
• Speech-Language Pathologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.