NPIMap

Organization Active NPI

Premium Communication Services, Inc.

  • Speech-Language Pathologist
  • Waldorf, MD
National Provider Identifier
1851829014
Registry record updated May 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
03489 Issued in MD
Legal business name
PREMIUM COMMUNICATION SERVICES, INC.
Practice address
3261 Old Washington Rd Ste 2020
Waldorf, MD 20602-3231
Phone
(240) 492-6111
NPI assigned
May 31, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Anita Galloway Wyatt, MS, CCC-SLP
Title
President/Ceo
Phone
(240) 492-6111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 03489 MD Primary

Addresses

Primary practice location

3261 Old Washington Rd Ste 2020
Waldorf, MD 20602-3231

Mailing address

9823 Sandpiper Dr
Upper Marlboro, MD 20772-4762

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496188800000",
    "number": "1851829014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9823 SANDPIPER DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207724762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3261 OLD WASHINGTON RD STE 2020",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023231",
            "telephone_number": "240-492-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM COMMUNICATION SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-31",
        "last_updated": "2017-05-31",
        "status": "A",
        "authorized_official_last_name": "WYATT",
        "authorized_official_first_name": "ANITA",
        "authorized_official_middle_name": "GALLOWAY",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "240-492-6111",
        "authorized_official_credential": "MS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "03489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.

Verify at the official NPI Registry.