Active NPI
Katherine Gomez
- Student in an Organized Health Care Education/Training Program
- Miami, FL
National Provider Identifier
1063758225
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 12930 SW 128TH St
Suit 204A1
Miami, FL 33186 - Phone
- (305) 562-4683
- NPI assigned
- Dec 17, 2012
- Last updated
- Jul 16, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | FL | Primary |
Addresses
Primary practice location
12930 SW 128TH St
Suit 204A1
Miami, FL 33186
Mailing address
12930 SW 128TH St
Suite 204A1
Miami, FL 33186-6038
Phone (305) 562-4683
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Shaping Academy for Behavioral Development | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Miami, FL
- NPI 1710157052
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373932800000",
"number": "1063758225",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12930 SW 128TH ST",
"address_2": "SUITE 204A1",
"city": "MIAMI",
"state": "FL",
"postal_code": "331866038",
"telephone_number": "305-562-4683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12930 SW 128TH ST",
"address_2": "SUIT 204A1",
"city": "MIAMI",
"state": "FL",
"postal_code": "33186",
"telephone_number": "305-562-4683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "KATHERINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-12-17",
"last_updated": "2013-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.