Active NPI
Isabel Martin, CCC-SLP
- Speech-Language Pathologist
- Riverdale Park, MD
National Provider Identifier
1386115194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 08852
- Practice address
- 4703 Ravenswood Rd Apt 18
Riverdale Park, MD 20737-1155 - Phone
- (978) 509-4966
- NPI assigned
- Dec 6, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 08852 | MD | Primary |
Addresses
Primary practice location
4703 Ravenswood Rd Apt 18
Riverdale Park, MD 20737-1155
Mailing address
4703 Ravenswood Rd Apt 18
Riverdale Park, MD 20737-1155
Phone (978) 509-4966
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
| License | State | Type | Specialty |
|---|---|---|---|
| 08852 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544054400000",
"number": "1386115194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4703 RAVENSWOOD RD APT 18",
"city": "RIVERDALE PARK",
"state": "MD",
"postal_code": "207371155",
"telephone_number": "978-509-4966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4703 RAVENSWOOD RD APT 18",
"city": "RIVERDALE PARK",
"state": "MD",
"postal_code": "207371155",
"telephone_number": "978-509-4966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "ISABEL",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-12-06",
"last_updated": "2018-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": "08852",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverdale Park, MD
- Hot Yoga Riverdale (BikramYogaWorks)
- Monique Julien, DC
- Jenny Youn Kang, DDS
- Mutiat Komolafe Olanipekun
- William Alberto Lanza, DDS
- Miluska Masaschi-Sanchez, DDS
- Metro Mental Healthcare, LLC
- Pediatric Dentistry of Maryland, LLC (Riverdale Park Pediatric Dentistry)
- Physical Therapy and Pain Management Center LLC (College Park Physical Therapy & Hand Rehabilitation)
- Prime Health and Wellness LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.