Active NPI
Ruthanne Doetzer
- Speech-Language Pathologist
- Baltimore, MD
National Provider Identifier
1497037469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 06122
- Practice address
- 1750 E Fairmount Ave
Baltimore, MD 21231-1534 - Phone
- (443) 923-9100
- NPI assigned
- Sep 15, 2011
- 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 | 06122 | MD | Primary |
Addresses
Primary practice location
1750 E Fairmount Ave
Baltimore, MD 21231-1534
Mailing address
101 Springside Dr
Timonium, MD 21093-3444
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06122 | Other | MD | MARYLAND LIC. REG. CERT. NO. |
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 |
|---|---|---|---|
| 06122 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316044800000",
"number": "1497037469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 SPRINGSIDE DR",
"city": "TIMONIUM",
"state": "MD",
"postal_code": "210933444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1750 E FAIRMOUNT AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212311534",
"telephone_number": "443-923-9100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOETZER",
"first_name": "RUTHANNE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-15",
"last_updated": "2011-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": "06122",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MARYLAND LIC. REG. CERT. NO.",
"identifier": "06122",
"state": "MD"
}
],
"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 Sep 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.