Individual provider Active NPI

Kirsten Ferguson

  • Speech-Language Pathologist
  • Pasadena, MD
National Provider Identifier
1740510981
Registry record updated Jan 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
01291 Issued in MD
Practice address
1645 Braid Hills Dr
Pasadena, MD 21122-3533
Phone
(410) 370-0158
NPI assigned
Jan 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2010

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 01291 MD Primary

Addresses

Primary practice location

1645 Braid Hills Dr
Pasadena, MD 21122-3533

Mailing address

1645 Braid Hills Dr
Pasadena, MD 21122-3533
Phone (410) 370-0158

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230628004253 MD Practitioner - Qualified Speech Language Pathologist 6608235338 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01291MDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cypress Creek Therapy Associates LLC Speech-Language Pathologist CurrentSince Jun 5, 2023 Accepting new patients

Locations

20 Mayo Rd
Ste 205
Edgewater, MD 21037
Phone (410) 384-9242

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1263168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263168000000",
    "number": "1740510981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 BRAID HILLS DR",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211223533",
            "telephone_number": "410-370-0158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 BRAID HILLS DR",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211223533",
            "telephone_number": "410-370-0158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "KIRSTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-11",
        "last_updated": "2010-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "01291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; 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.