Individual provider Active NPI

M Kim McSorley

  • Speech-Language Pathologist
  • Centreville, MD
National Provider Identifier
1750852133
Registry record updated Dec 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
00786 Issued in MD
Practice address
202 Chesterfield Ave
Centreville, MD 21617-1308
Phone
(410) 758-2403
NPI assigned
Dec 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2018

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 00786 MD Primary

Addresses

Primary practice location

202 Chesterfield Ave
Centreville, MD 21617-1308

Mailing address

202 Fairview Dr
Chestertown, MD 21620-2883
Phone (410) 778-3116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Queen Anne'S County Board of Education Past Accepting new patients
Queen Anne'S County Board of Education Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1544486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544486400000",
    "number": "1750852133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 FAIRVIEW DR",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216202883",
            "telephone_number": "410-778-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 CHESTERFIELD AVE",
            "city": "CENTREVILLE",
            "state": "MD",
            "postal_code": "216171308",
            "telephone_number": "410-758-2403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCSORLEY",
        "first_name": "M",
        "middle_name": "KIM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-11",
        "last_updated": "2018-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "00786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; 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.