Active NPI
Jennifer Vandenberge, S.L.P.
- Speech-Language Pathologist
- Towson, MD
National Provider Identifier
1992847149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 03549
- Practice address
- 7401 Osler Dr
Suite 110
Towson, MD 21204-7673 - Phone
- (410) 296-8888
- NPI assigned
- Feb 13, 2007
- 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 | 03549 | MD | Primary |
Addresses
Primary practice location
7401 Osler Dr
Suite 110
Towson, MD 21204-7673
Mailing address
7063 Saddle Dr
Sykesville, MD 21784-5936
Phone (410) 549-5501
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 621764 | Other | MD | BC BS |
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 |
|---|---|---|---|
| 03549 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992847149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7063 SADDLE DR",
"city": "SYKESVILLE",
"state": "MD",
"postal_code": "217845936",
"telephone_number": "410-549-5501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7401 OSLER DR",
"address_2": "SUITE 110",
"city": "TOWSON",
"state": "MD",
"postal_code": "212047673",
"telephone_number": "410-296-8888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDENBERGE",
"first_name": "JENNIFER",
"name_prefix": "Miss",
"credential": "S.L.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": "03549",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS",
"identifier": "621764",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Towson, MD
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.