Individual provider Active NPI

Tiara Booth, SLP

  • Speech-Language Pathologist
  • Lanham, MD
National Provider Identifier
1497395693
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
09346 Issued in MD
Practice address
2900 Campus Way N
Lanham, MD 20706-2892
Phone
(301) 276-9153
NPI assigned
Jan 15, 2020
Last updated
Oct 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 01818L MD
Speech-Language Pathologist 235Z00000X 2202010198 VA
Speech-Language Pathologist 235Z00000X 09346 MD Primary

Addresses

Primary practice location

2900 Campus Way N
Lanham, MD 20706-2892

Mailing address

2900 Campus Way N
Lanham, MD 20706-2892
Phone (301) 276-9153

Other identifiers 3

IdentifierTypeStateIssuer
2202010198OtherVASTATE DEPARTMENT OF HEALTH
09346OtherMDSTATE DEPARTMENT OF HEALTH
01818LOtherMDSTATE DEPARTMENT OF HEALTH

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

LicenseStateTypeSpecialty
09346MDMDClinical Social Worker
01818LMDMDSpeech-Language Pathologist
2202010198VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Professional Rehabilitation Services, Inc. Speech-Language Pathologist PastSince Jan 1, 2020 Accepting new patients
Rehabilitation Services, Inc. Speech-Language Pathologist PastSince Jan 1, 2020 Accepting new patients

Organizations & group practices 2

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": "1579046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1497395693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CAMPUS WAY N",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207062892",
            "telephone_number": "301-276-9153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 CAMPUS WAY N",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207062892",
            "telephone_number": "301-276-9153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "TIARA",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-15",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "01818L",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202010198",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "09346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE DEPARTMENT OF HEALTH",
            "identifier": "2202010198",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE DEPARTMENT OF HEALTH",
            "identifier": "09346",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE DEPARTMENT OF HEALTH",
            "identifier": "01818L",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.