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OPTIMAL BEGINNINGS, LLC
Complete NPI Record 1265812895
Speech-Language Pathologist in Bethesda, MD

NPI Status: Active since June 09, 2015

Contact Information

5272 RIVER RD
SUITE 300
BETHESDA, MD
ZIP 20816
Phone: (301) 718-1716
Fax: (301) 718-1766

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Second Line Business Mailing Address
  7. Provider Business Mailing Address City Name
  8. Provider Business Mailing Address State Name
  9. Provider Business Mailing Address Postal Code
  10. Provider Business Mailing Address Country Code If outside U S
  11. Provider Business Mailing Address Telephone Number
  12. Provider Business Mailing Address Fax Number
  13. Provider First Line Business Practice Location Address
  14. Provider Second Line Business Practice Location Address
  15. Provider Business Practice Location Address City Name
  16. Provider Business Practice Location Address State Name
  17. Provider Business Practice Location Address Postal Code
  18. Provider Business Practice Location Address Country Code If outside U S
  19. Provider Business Practice Location Address Telephone Number
  20. Provider Business Practice Location Address Fax Number
  21. Provider Enumeration Date
  22. Last Update Date
  23. Authorized Official Last Name
  24. Authorized Official First Name
  25. Authorized Official Title or Position
  26. Authorized Official Telephone Number
  27. Healthcare Provider Taxonomy Code 1
  28. Provider License Number State Code 1
  29. Healthcare Provider Primary Taxonomy Switch 1
  30. Healthcare Provider Taxonomy Code 2
  31. Provider License Number State Code 2
  32. Healthcare Provider Primary Taxonomy Switch 2
  33. Healthcare Provider Taxonomy Code 3
  34. Provider License Number State Code 3
  35. Healthcare Provider Primary Taxonomy Switch 3
  36. Other Provider Identifier 1
  37. Other Provider Identifier Type Code 1
  38. Other Provider Identifier State 1
  39. Other Provider Identifier Issuer 1
  40. Other Provider Identifier 2
  41. Other Provider Identifier Type Code 2
  42. Other Provider Identifier State 2
  43. Other Provider Identifier Issuer 2
  44. Other Provider Identifier 3
  45. Other Provider Identifier Type Code 3
  46. Other Provider Identifier State 3
  47. Other Provider Identifier Issuer 3
  48. Other Provider Identifier 4
  49. Other Provider Identifier Type Code 4
  50. Other Provider Identifier State 4
  51. Other Provider Identifier Issuer 4
  52. Other Provider Identifier 5
  53. Other Provider Identifier Type Code 5
  54. Other Provider Identifier State 5
  55. Other Provider Identifier Issuer 5
  56. Other Provider Identifier 6
  57. Other Provider Identifier Type Code 6
  58. Other Provider Identifier State 6
  59. Other Provider Identifier 7
  60. Other Provider Identifier Type Code 7
  61. Other Provider Identifier State 7
  62. Other Provider Identifier Issuer 7
  63. Other Provider Identifier 8
  64. Other Provider Identifier Type Code 8
  65. Other Provider Identifier State 8
  66. Other Provider Identifier Issuer 8
  67. Other Provider Identifier 9
  68. Other Provider Identifier Type Code 9
  69. Other Provider Identifier State 9
  70. Other Provider Identifier 10
  71. Other Provider Identifier Type Code 10
  72. Other Provider Identifier State 10
  73. Other Provider Identifier Issuer 10
  74. Other Provider Identifier 11
  75. Other Provider Identifier Type Code 11
  76. Other Provider Identifier State 11
  77. Other Provider Identifier Issuer 11
  78. Other Provider Identifier 12
  79. Other Provider Identifier Type Code 12
  80. Other Provider Identifier State 12
  81. Other Provider Identifier Issuer 12
  82. Other Provider Identifier 13
  83. Other Provider Identifier Type Code 13
  84. Other Provider Identifier State 13
  85. Other Provider Identifier Issuer 13
  86. Other Provider Identifier 14
  87. Other Provider Identifier Type Code 14
  88. Other Provider Identifier State 14
  89. Other Provider Identifier 15
  90. Other Provider Identifier Type Code 15
  91. Other Provider Identifier State 15
  92. Other Provider Identifier Issuer 15
  93. Is Organization Subpart
  94. Healthcare Provider Taxonomy Group 1
  95. Healthcare Provider Taxonomy Group 2
  96. Healthcare Provider Taxonomy Group 3

Complete NPI Dataset

This page represents the complete record for NPI 1265812895. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1265812895
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address: 5272 RIVER RD
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Second Line Business Mailing Address: SUITE 300
The second line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider second line location address’’.
Provider Business Mailing Address City Name: BETHESDA
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: MD
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 208161405
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 3017181716
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 3017181766
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 5272 RIVER RD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location Address: SUITE 300
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: BETHESDA
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: MD
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 208161405
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 3017181716
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 3017181766
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 6/9/2015
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 5/2/2016
The date that a record was last updated or changed.
Authorized Official Last Name: VISALLI-GOLD
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: DANA
The first name of the authorized official.
Authorized Official Title or Position: OWNER/CEO
The title or position of the authorized official.
Authorized Official Telephone Number: 3017181716
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 103K00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number State Code 1: MD
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: N
Healthcare Provider Taxonomy Code 2: 1041C0700X
Provider License Number State Code 2: MD
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 2: N
Healthcare Provider Taxonomy Code 3: 235Z00000X
Provider License Number State Code 3: MD
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 3: Y
Other Provider Identifier 1: 0145840
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: TN
Other Provider Identifier Issuer 1: BACB
Other Provider Identifier 2: 11314065
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 2: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 2: MD
Other Provider Identifier Issuer 2: BACB
Other Provider Identifier 3: 1107456
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 3: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 3: MO
Other Provider Identifier Issuer 3: BACB
Other Provider Identifier 4: 11210359
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 4: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 4: MD
Other Provider Identifier Issuer 4: BACB
Other Provider Identifier 5: 1062969
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 5: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 5: MD
Other Provider Identifier Issuer 5: BACB
Other Provider Identifier 6: 980005100
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 6: 05
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 6: MD
Other Provider Identifier 7: 17943
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 7: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 7: MD
Other Provider Identifier Issuer 7: DEPARTMENT OF HEALTH AND MENTAL HYGIENE
Other Provider Identifier 8: 1063014
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 8: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 8: MD
Other Provider Identifier Issuer 8: BACB
Other Provider Identifier 9: 745321
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 9: 05
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 9: MD
Other Provider Identifier 10: 1118018
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 10: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 10: GA
Other Provider Identifier Issuer 10: BACB
Other Provider Identifier 11: 1096383
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 11: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 11: CA
Other Provider Identifier Issuer 11: BACB
Other Provider Identifier 12: 146026
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 12: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 12: MD
Other Provider Identifier Issuer 12: BACB
Other Provider Identifier 13: 173745
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 13: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 13: MD
Other Provider Identifier Issuer 13: BACB
Other Provider Identifier 14: 9641025 00
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 14: 05
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 14: MD
Other Provider Identifier 15: 1149981
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 15: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 15: MA
Other Provider Identifier Issuer 15: BACB
Is Organization Subpart: N
Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP
Healthcare Provider Taxonomy Group 2: 193200000X MULTI-SPECIALTY GROUP
Healthcare Provider Taxonomy Group 3: 193200000X MULTI-SPECIALTY GROUP