Active NPI
Kendra Davis Reines, CCC-SLP
- Speech-Language Pathologist
- Ellicott City, MD
National Provider Identifier
1841458528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 04483
- Practice address
- 3421 Martha Bush Dr
Ellicott City, MD 21043-4426 - Phone
- (410) 465-1352
- NPI assigned
- May 29, 2008
- Sex
- Female
- Sole proprietor
- No
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 | 04483 | MD | Primary |
Addresses
Primary practice location
3421 Martha Bush Dr
Ellicott City, MD 21043-4426
Mailing address
3421 Martha Bush Dr
Ellicott City, MD 21043-4426
Phone (410) 465-1352
Other practice location 1
18 Delrey Ave
Catonsville, MD 21228
Phone (410) 744-3151
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04483 | MD | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Linwood Center, Inc. | Past | Accepting new patients | |
| United Cerebral Palsy of CM, Inc. | Past | Accepting new patients | |
| United Cerebral Palsy of Central MD Inc | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Local Education Agency (LEA)
- Ellicott City, MD
- NPI 1043373699
-
- Physical Therapist
- Catonsville, MD
- NPI 1609038306
Speech-Language Pathologist
-
- Developmentally Disabled Services Day Training Agency
- Baltimore, MD
- NPI 1285768358
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571702400000",
"number": "1841458528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3421 MARTHA BUSH DR",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210434426",
"telephone_number": "410-465-1352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3421 MARTHA BUSH DR",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210434426",
"telephone_number": "410-465-1352"
}
],
"practiceLocations": [
{
"address_1": "18 Delrey Ave",
"address_purpose": "LOCATION",
"city": "Catonsville",
"state": "MD",
"postal_code": "21228",
"country_code": "US",
"telephone_number": "410-744-3151",
"fax_number": "410-744-8467",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REINES",
"first_name": "KENDRA",
"middle_name": "DAVIS",
"name_prefix": "Mrs.",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-29",
"last_updated": "2019-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": "04483",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellicott City, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.