Individual provider Active NPI

Geralynn S Knorr

  • Speech-Language Pathologist
  • Culver City, CA
National Provider Identifier
1841409844
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5009 Issued in CA
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

Updated by the provider on Jul 8, 2007

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 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

IdentifierTypeStateIssuer
ZZZ26078ZOtherCABLUE SHIELD OF CA PIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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.

Verify at the official NPI Registry.