Active NPI
Kathleen Deery Suffredini, MA, PT
- Specialist
- Rockville, MD
National Provider Identifier
1841208287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 15701
- Practice address
- 932 Hungerford Dr
Ste 35a
Rockville, MD 20850-1753 - Phone
- (301) 340-6413
- Fax
- (301) 340-0669
- NPI assigned
- Aug 3, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 15701 | MD | Primary |
Addresses
Primary practice location
932 Hungerford Dr
Ste 35a
Rockville, MD 20850-1753
Mailing address
6 Rice CT
Rockville, MD 20850-1149
Phone (301) 340-9269
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 983700100 | Medicaid | MD |
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)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15701 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1495152000000",
"number": "1841208287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 RICE CT",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208501149",
"telephone_number": "301-340-9269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "932 HUNGERFORD DR",
"address_2": "STE 35A",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208501753",
"telephone_number": "301-340-6413",
"fax_number": "301-340-0669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUFFREDINI",
"first_name": "KATHLEEN",
"middle_name": "DEERY",
"name_prefix": "Mrs.",
"credential": "MA, PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-03",
"last_updated": "2017-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MD",
"license": "15701",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "983700100",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.