Individual provider Active NPI

Asia Blackwell, SLP

  • Speech-Language Pathologist
  • Randallstown, MD
National Provider Identifier
1477079929
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202012499 Issued in VA
Practice address
3916 Roxanne Rd
Randallstown, MD 21133-4025
Phone
(443) 682-5580
NPI assigned
Aug 16, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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 2202012499 VA Primary
Speech-Language Pathologist 235Z00000X 08410 MD

Addresses

Primary practice location

3916 Roxanne Rd
Randallstown, MD 21133-4025

Mailing address

3916 Roxanne Rd
Randallstown, MD 21133-4025
Phone (443) 682-5880

Other practice location 1

2500 Wallington Way Ste 103
Marriottsville, MD 21104-1506
Phone (410) 442-9791

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210114001662 MD Practitioner - Qualified Speech Language Pathologist 0345653242 Reassigns benefits to 2 organizations
I20260611003608 VA Practitioner - Qualified Speech Language Pathologist 0345653242 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7600 Chevy Chase Dr
Suite 300
Austin, TX 78752-1503

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08410MDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Speech Cove LLC Speech-Language Pathologist CurrentSince Oct 4, 2020 Accepting new patients
Proactive Therapy, LLC CurrentSince Oct 10, 2020 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1477079929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3916 ROXANNE RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211334025",
            "telephone_number": "443-682-5880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3916 ROXANNE RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211334025",
            "telephone_number": "443-682-5580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Wallington Way Ste 103",
            "address_purpose": "LOCATION",
            "city": "Marriottsville",
            "state": "MD",
            "postal_code": "211041506",
            "country_code": "US",
            "telephone_number": "410-442-9791",
            "fax_number": "410-442-9783",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "ASIA",
        "name_prefix": "Miss",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-16",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202012499",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "08410",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randallstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.