Individual provider Active NPI

Samara Shalom, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Pikesville, MD
National Provider Identifier
1679874507
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
1700 Reisterstown Rd Ste 226
Pikesville, MD 21208-1416
Phone
(410) 394-8794
NPI assigned
Nov 9, 2010
Last updated
May 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 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 Primary

Addresses

Primary practice location

1700 Reisterstown Rd Ste 226
Pikesville, MD 21208-1416

Mailing address

1700 Reisterstown Rd Ste 219
Pikesville, MD 21208-2920
Phone (410) 394-8794

Other practice location 1

1498 Reisterstown Rd
339
Pikesville, MD 21208-3817
Phone (618) 974-9818

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230329001094 MD Practitioner - Qualified Speech Language Pathologist 4789058983 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Speech Leap, LLC Pediatrics CurrentSince Nov 23, 2022 Accepting new patients
Speech Leap, LLC Speech-Language Pathologist Current Accepting new patients

Locations

1498 Reisterstown Rd
#339
Pikesville, MD 21208
Phone (410) 394-8794

1700 Reisterstown Rd
Ste 226
Pikesville, MD 21208
Phone (410) 394-8794

1700 Reisterstown Rd
Ste 231
Pikesville, MD 21208
Phone (400) 541-0846

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": "1289260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1679874507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 REISTERSTOWN RD STE 219",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212082920",
            "telephone_number": "410-394-8794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 REISTERSTOWN RD STE 226",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212081416",
            "telephone_number": "410-394-8794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1498 Reisterstown Rd",
            "address_2": "339",
            "address_purpose": "LOCATION",
            "city": "Pikesville",
            "state": "MD",
            "postal_code": "212083817",
            "country_code": "US",
            "telephone_number": "618-974-9818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHALOM",
        "first_name": "SAMARA",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-09",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pikesville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.