Individual provider Active NPI

Rebecca S Randall, CCC-SLP

  • Speech-Language Pathologist
  • Westminster, MD
National Provider Identifier
1366563447
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
02242 Issued in MD
Practice address
511 Jermor LN Ste 102
Westminster, MD 21157
Phone
(410) 871-2494
NPI assigned
Apr 3, 2007
Last updated
Nov 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2019

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 02242 MD Primary

Addresses

Primary practice location

511 Jermor LN Ste 102
Westminster, MD 21157

Mailing address

511 Jermor LN Ste 102
Westminster, MD 21157-6152

Other practice location 1

707 N Broadway
Baltimore, MD 21205-1832
Phone (443) 923-1886

Other practice location 2

707 N Broadway
Baltimore, MD 21205-1832
Phone (443) 923-1886

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191212000861 MD Practitioner - Qualified Speech Language Pathologist 2769815315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Assisted Rehab. IncorporatedGroup PAC ID 9830144591, 14 clinicians

Practice addresses (Care Compare)

615 Chestnut Ave
Towson, MD 21204-3742
Phone (410) 825-7423

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Assisted Rehab. Incorporated Speech-Language Pathologist CurrentSince Oct 24, 2025 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, 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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1366563447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 JERMOR LN STE 102",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211576152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 JERMOR LN STE 102",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "21157",
            "telephone_number": "410-871-2494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "707 N Broadway",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212051832",
            "country_code": "US",
            "telephone_number": "443-923-1886",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "707 N Broadway",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212051832",
            "country_code": "US",
            "telephone_number": "443-923-1886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "REBECCA",
        "middle_name": "S",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "02242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.