Individual provider Active NPI

Jerilyn Deitch, MA/CCC-SLP

  • Speech-Language Pathologist
  • Annapolis, MD
National Provider Identifier
1497225288
Registry record updated Dec 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
03995 Issued in MD
Practice address
Anne Arundel County Public Schools
2644 Riva Rd
Annapolis, MD 21401
Phone
(410) 222-5000
NPI assigned
Dec 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2018

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 03995 MD Primary

Addresses

Primary practice location

Anne Arundel County Public Schools
2644 Riva Rd
Annapolis, MD 21401

Mailing address

900 Forked Creek Rd
Arnold, MD 21012-1729
Phone (410) 746-5917

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

LicenseStateTypeSpecialty
03995MDMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1543968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1497225288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 FORKED CREEK RD",
            "city": "ARNOLD",
            "state": "MD",
            "postal_code": "210121729",
            "telephone_number": "410-746-5917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ANNE ARUNDEL COUNTY PUBLIC SCHOOLS",
            "address_2": "2644 RIVA RD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "21401",
            "telephone_number": "410-222-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEITCH",
        "first_name": "JERILYN",
        "name_prefix": "Mrs.",
        "credential": "MA/CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-05",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "03995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2018; 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.