Courtney Ferris Fitzgerald, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL60886875 Issued in WA

Practice address

9343 Sportsman Club Rd NE
Bainbridge Island, WA 98110-3642

Phone

(206) 780-6520

NPI assigned

Oct 1, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Ms. Courtney Ferris Dreiling Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1548801541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14464 KOMEDAL RD NE",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981101021",
            "telephone_number": "951-333-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9343 SPORTSMAN CLUB RD NE",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981103642",
            "telephone_number": "206-780-6520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27089 Highland Rd NE",
            "address_purpose": "LOCATION",
            "city": "Kingston",
            "state": "WA",
            "postal_code": "983468408",
            "country_code": "US",
            "telephone_number": "360-396-3722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "COURTNEY",
        "middle_name": "FERRIS",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-01",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP15986",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL60886875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA STATE SLP, AUD, AND HEARING AID DISPERNSERS BOARD",
            "identifier": "SP15986",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF WA OSPI",
            "identifier": "560428E",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA DEPT OF HEALTH",
            "identifier": "LL60886875",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "DREILING",
            "middle_name": "FERRIS",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Speech-Language Pathologist in Bainbridge Island, WA
• Providers in Bainbridge Island, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; 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.