Active NPI
Geralynn S Knorr
- Speech-Language Pathologist
- Culver City, CA
National Provider Identifier
1841409844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 5009
- Practice address
- 11103 Fairbanks Way
Culver City, CA 90230-4946 - Phone
- (310) 880-5504
- NPI assigned
- May 22, 2007
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 5009 | CA | Primary |
Addresses
Primary practice location
11103 Fairbanks Way
Culver City, CA 90230-4946
Mailing address
11103 Fairbanks Way
Culver City, CA 90230-4946
Phone (310) 880-5504
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ26078Z | Other | CA | BLUE SHIELD OF CA PIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130502000210 | CA | Practitioner - Qualified Speech Language Pathologist | 8820235245 | Practice locations: Culver City, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
11103 Fairbanks Way
Culver City, CA 90230-4946
Phone (310) 880-5504
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1841409844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11103 FAIRBANKS WAY",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902304946",
"telephone_number": "310-880-5504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11103 FAIRBANKS WAY",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902304946",
"telephone_number": "310-880-5504"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNORR",
"first_name": "GERALYNN",
"middle_name": "S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "5009",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF CA PIN",
"identifier": "ZZZ26078Z",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Culver City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.