Nyla Funderburk

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

07371 Issued in MD

Practice address

701 King Farm Blvd
Rockville, MD 20850-6165

Phone

(240) 449-9015

NPI assigned

Aug 4, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1730598780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 KING FARM BLVD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208506165",
            "telephone_number": "240-449-9015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 KING FARM BLVD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208506165",
            "telephone_number": "240-449-9015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Dexter Ct",
            "address_purpose": "LOCATION",
            "city": "Willingboro",
            "state": "NJ",
            "postal_code": "080463163",
            "country_code": "US",
            "telephone_number": "888-265-2680 x247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUNDERBURK",
        "first_name": "NYLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-04",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "07371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Rockville, MD
• Providers in Rockville, MD by specialty
• Speech-Language Pathologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2019; 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.