NPIMap

Organization Active NPI

Illuminate Pediatric Therapies LLC

  • Hearing and Speech Clinic/Center
  • Baltimore, MD
National Provider Identifier
1659078640
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X
Legal business name
ILLUMINATE PEDIATRIC THERAPIES LLC
Practice address
3806 Claremont St
Baltimore, MD 21224-2510
Phone
(845) 242-6369
NPI assigned
Feb 10, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Authorized official

Name
Briana Claire Cabibbo Gilliams, M.S., CCC-SLPNPI 1942736830
Title
Owner/Speech-Language Pathologist
Phone
(845) 242-6369

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing and Speech Clinic/Center 261QH0700X Primary

Addresses

Primary practice location

3806 Claremont St
Baltimore, MD 21224-2510

Mailing address

3717 Boston St # 344
Baltimore, MD 21224-5752

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1675987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696291200000",
    "number": "1659078640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3717 BOSTON ST # 344",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212245752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3806 CLAREMONT ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242510",
            "telephone_number": "845-242-6369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLUMINATE PEDIATRIC THERAPIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-10",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A",
        "authorized_official_last_name": "GILLIAMS",
        "authorized_official_first_name": "BRIANA",
        "authorized_official_middle_name": "CLAIRE CABIBBO",
        "authorized_official_title_or_position": "OWNER/SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "845-242-6369",
        "authorized_official_credential": "M.S., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 3, 2023; 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.