Active NPI
Sheyla Kemille Williams-Geronimo, M.A. CCC-SLP
- Speech-Language Pathologist
- Elkton, MD
National Provider Identifier
1457994600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 09244
- Practice address
- 203 E Thomson Dr
Elkton, MD 21921-6245 - Phone
- (410) 996-5080
- NPI assigned
- Oct 21, 2019
- Last updated
- Oct 21, 2019
- Sex
- Female
- Sole proprietor
- No
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 | 09244 | MD | Primary |
Addresses
Primary practice location
203 E Thomson Dr
Elkton, MD 21921-6245
Mailing address
203 E Thomson Dr
Elkton, MD 21921-6245
Phone (410) 996-5080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09244 | Medicaid | MD |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09244 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571616000000",
"number": "1457994600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "203 E THOMSON DR",
"city": "ELKTON",
"state": "MD",
"postal_code": "219216245",
"telephone_number": "410-996-5080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "203 E THOMSON DR",
"city": "ELKTON",
"state": "MD",
"postal_code": "219216245",
"telephone_number": "410-996-5080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS-GERONIMO",
"first_name": "SHEYLA",
"middle_name": "KEMILLE",
"credential": "M.A. CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-21",
"last_updated": "2019-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": "09244",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "09244",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elkton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.