Individual provider Active NPI

Rebecca Gorman

  • Speech-Language Pathologist
  • Baltimore, MD
National Provider Identifier
1447873468
Registry record updated May 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
05503 Issued in MD
Practice address
1708 W Rogers Ave
Baltimore, MD 21209-4596
Phone
(410) 578-5341
NPI assigned
May 26, 2020
Last updated
May 26, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2020

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 05503 MD Primary

Addresses

Primary practice location

1708 W Rogers Ave
Baltimore, MD 21209-4596

Mailing address

1708 W Rogers Ave
Baltimore, MD 21209-4596
Phone (410) 578-5341

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210721003898 MD Practitioner - Qualified Speech Language Pathologist 6103229646 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Baltimore Medical Center, Inc. CurrentSince Jul 1, 2021 Accepting new patients
Greater Baltimore Medical Center, Inc. CurrentSince Jul 1, 2021 Accepting new patients
Greater Baltimore Medical Center, Inc Current Accepting new patients

Locations

6569 N Charles St
Ste 307
Towson, MD 21204
Phone (443) 849-2767

6701 N Charles St
Ste 102
Towson, MD 21204
Phone (443) 849-2459

Organizations & group practices 3

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": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1447873468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 W ROGERS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212094596",
            "telephone_number": "410-578-5341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 W ROGERS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212094596",
            "telephone_number": "410-578-5341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMAN",
        "first_name": "REBECCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-26",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "05503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.