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Deactivated NPI 1992781868 Deactivated / Inactive NPI Female Practitioner

Kanessia Shepard , MA, CCC-SLP

Speech-Language Pathologist • Upper Marlboro, MD

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Kanessia Shepard has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 21, 2005
NPI Deactivation Date March 20, 2026
Total Practice Duration ~21 Years of Practice (2005 – 2026)

Professional Overview & Biography Verified Profile Summary

Kanessia Shepard, MA, CCC-SLP was a registered Speech-Language Pathologist practicing in Upper Marlboro, MD. Throughout an active medical career spanning 21 years, Kanessia Shepard provided care at the practice location at 9716 LAKE POINTE CT APT 101 until profile deactivation on 2026-03-20.

Practice Location & Contact Primary Location

Practice Address

9716 Lake Pointe Ct Apt 101

Upper Marlboro, MD 207744714

Telephone 2407887089
Fax 2407887089

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Upper Marlboro, MD

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 18.0 Yrs
State Avg: 14.1 Yrs
Regional Practice Density
39 Specialists

Practicing in Upper Marlboro, MD (4547 Statewide)

Telehealth Adoption Rate
2.6% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License MD 05330

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
7412441 (NC)
Commercial Insurance / Payer ID Nc Bcbs
141EN (NC)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
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NPI Profile Reactivated March 26, 2026

Record officially reactivated for active practice on March 26, 2026

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NPI Profile Deactivated March 20, 2026

Record deactivated on March 20, 2026

NPI Profile Active September 22, 2009

NPI status registered as active in NPPES database

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Updated Practice Location September 22, 2009

Registered at 9716 LAKE POINTE CT APT 101, UPPER MARLBORO, MD 207744714 (Tel: 2407887089)

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Updated Business Mailing Address September 22, 2009

Registered at 9716 LAKE POINTE CT APT 101, UPPER MARLBORO, MD 207744714 (Tel: 2407887089)

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Provider Name / Credentials Updated September 22, 2009

Recorded as KANESSIA SHEPARD, MA, CCC-SLP

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 22, 2009

Speech-Language Pathologist (License #05330 in MD)

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Initial NPI Registration & Enumeration December 21, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1992781868
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 21, 2005
Last Update: March 26, 2026
Deactivation Date: March 20, 2026
Sole Proprietor: Yes

Mailing Address

9716 Lake Pointe Ct Apt 101

Upper Marlboro, MD 207744714

Phone: 2407887089

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.