Individual provider Active NPI

Patricia Williams

  • Speech-Language Pathologist
  • Rosedale, MD
National Provider Identifier
1396082905
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
08160 Issued in MD
Practice address
1717 Weyburn Rd
Rosedale, MD 21237-1722
Phone
(410) 887-0506
NPI assigned
Jan 16, 2013
Last updated
Apr 24, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SL009486 PA
Speech-Language Pathologist 235Z00000X 08160 MD Primary

Addresses

Primary practice location

1717 Weyburn Rd
Rosedale, MD 21237-1722

Mailing address

3903 Walters Rd
Edgewood, MD 21040-3722
Phone (845) 242-1651

Other identifiers 1

IdentifierTypeStateIssuer
SL009486OtherPABUREAU OF PROFESSIONAL OCCUPATIONAL AFFAIRS

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
08160MDMDSpeech-Language Pathologist
SL009486PAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1358294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1396082905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 WALTERS RD",
            "city": "EDGEWOOD",
            "state": "MD",
            "postal_code": "210403722",
            "telephone_number": "845-242-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 WEYBURN RD",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212371722",
            "telephone_number": "410-887-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "PATRICIA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-16",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL009486",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "08160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUREAU OF PROFESSIONAL OCCUPATIONAL AFFAIRS",
            "identifier": "SL009486",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; 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.