Individual provider Active NPI

Serena Toni-Ann Kooh, M.S CCC-SLP

  • Speech-Language Pathologist
  • Hagerstown, MD
National Provider Identifier
1902308539
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
08853 Issued in MD
Practice address
10435 Downsville Pike
Hagerstown, MD 21740-1732
Phone
(301) 767-8878
NPI assigned
Feb 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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 08853 MD Primary

Addresses

Primary practice location

10435 Downsville Pike
Hagerstown, MD 21740-1732

Mailing address

39 Brittany CT
Elkton, MD 21921
Phone (347) 449-4304

Other practice location 1

1336 Belmont Ave
Salisbury, MD 21804-4500
Phone (410) 546-2894

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 Science

State licenses

LicenseStateTypeSpecialty
08853MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Easter Seals Delaware & Marylands Eastern Shore, Inc Speech-Language Pathologist Past Accepting new patients
World Speech Therapy LLC Speech-Language Pathologist PastSince Dec 13, 2022 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1902308539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 BRITTANY CT",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "21921",
            "telephone_number": "347-449-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10435 DOWNSVILLE PIKE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217401732",
            "telephone_number": "301-767-8878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1336 Belmont Ave",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "218044500",
            "country_code": "US",
            "telephone_number": "410-546-2894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOOH",
        "first_name": "SERENA",
        "middle_name": "TONI-ANN",
        "credential": "M.S CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-28",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "08853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.