Active NPI
Erin Boccardo, M.S. CCC-SLP
- Speech-Language Pathologist
- Manassas, VA
National Provider Identifier
1043719974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2202008819
- Practice address
- 9075 Park Ave
Manassas, VA 20110-4317 - Phone
- (571) 377-6215
- NPI assigned
- Feb 6, 2018
- 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 | 2202008819 | VA | Primary |
Addresses
Primary practice location
9075 Park Ave
Manassas, VA 20110-4317
Mailing address
10855 Gambril Dr Apt 11
Manassas, VA 20109-6583
Phone (609) 571-7099
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2202008819 | VA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517875200000",
"number": "1043719974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10855 GAMBRIL DR APT 11",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201096583",
"telephone_number": "609-571-7099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9075 PARK AVE",
"city": "MANASSAS",
"state": "VA",
"postal_code": "201104317",
"telephone_number": "571-377-6215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOCCARDO",
"first_name": "ERIN",
"credential": "M.S. CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-06",
"last_updated": "2018-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "VA",
"license": "2202008819",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manassas, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.