Individual provider Active NPI

Kerianna Krehbiel, CCC-SLP

  • Speech-Language Pathologist
  • Westminster, MD
National Provider Identifier
1508456864
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
09283 Issued in MD
Practice address
511 Jermor LN Ste 102
Westminster, MD 21157-6152
Phone
(410) 618-1090
NPI assigned
Jan 21, 2021
Last updated
May 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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 09283 MD Primary

Addresses

Primary practice location

511 Jermor LN Ste 102
Westminster, MD 21157-6152

Mailing address

8424 Cotoneaster Dr Apt 3B
Ellicott City, MD 21043-7357
Phone (302) 233-8425

Other practice location 1

3101 Fallstaff Rd
Baltimore, MD 21209-2967
Phone (410) 601-0842

Other names 1

  • Kerianna Frederick Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kfrederick@lifebridghealth.org Direct LifeBridge Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230601000762 MD Practitioner - Qualified Speech Language Pathologist 6103283429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therafit Enterprises IncGroup PAC ID 8921255688, 33 clinicians

Practice addresses (Care Compare)

511 Jermor LN
Suite 102
Westminster, MD 21157-6152
Phone (410) 871-2494

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
09283MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Therafit Enterprises, Inc. Speech-Language Pathologist Current Accepting new patients
Therafit Enterprises, Inc. Speech-Language Pathologist CurrentSince Apr 18, 2023 Accepting new patients
Therafit Enterprises, Inc. Speech-Language Pathologist CurrentSince Apr 18, 2023 Accepting new patients

Locations

1220 E Joppa Rd
Ste 109
Towson, MD 21286
Phone (410) 415-1992

511 Jermor Ln
Ste 102
Westminster, MD 21157
Phone (410) 415-1992

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, 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": "1611187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1508456864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8424 COTONEASTER DR APT 3B",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210437357",
            "telephone_number": "302-233-8425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 JERMOR LN STE 102",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211576152",
            "telephone_number": "410-618-1090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3101 Fallstaff Rd",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212092967",
            "country_code": "US",
            "telephone_number": "410-601-0842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KREHBIEL",
        "first_name": "KERIANNA",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-21",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "09283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kfrederick@lifebridghealth.org",
            "affiliation": "Y",
            "endpointDescription": "Secure professional email",
            "affiliationName": "LifeBridge Health",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3101 Fallstaff Rd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212092967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KERIANNA",
            "last_name": "FREDERICK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Westminster, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; 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.