Individual provider Active NPI

Carole Lynne Culberson Phillips, MD LICENSE, CCC-SLP

  • Speech-Language Pathologist
  • Ellicott City, MD
National Provider Identifier
1366912602
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
06781 Issued in MD
Practice address
10910 Clarksville Pike
Ellicott City, MD 21042
Phone
(410) 313-6600
NPI assigned
Nov 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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 06781 MD Primary

Addresses

Primary practice location

10910 Clarksville Pike
Ellicott City, MD 21042

Mailing address

7822 Rockburn Dr
Ellicott City, MD 21043-7071
Phone (443) 745-5205

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
06781MDMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1543449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1366912602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7822 ROCKBURN DR",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210437071",
            "telephone_number": "443-745-5205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10910 CLARKSVILLE PIKE",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "21042",
            "telephone_number": "410-313-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULBERSON PHILLIPS",
        "first_name": "CAROLE",
        "middle_name": "LYNNE",
        "name_prefix": "Ms.",
        "credential": "MD LICENSE, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-29",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "06781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; 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.