Jamie Gonnerman, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

3304 S M St
Fort Smith, AR 72903-2903

Phone

(479) 785-4677

NPI assigned

Aug 18, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eastern New Mexico University

  • Speech-Language Pathologist
  • Portales, NM
  • NPI 1356115273
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1073039335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 LECTA AVE",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729013515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3304 S M ST",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729032903",
            "telephone_number": "479-785-4677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S Ave K",
            "address_2": "Station 3, SHROC",
            "address_purpose": "LOCATION",
            "city": "Portales",
            "state": "NM",
            "postal_code": "88130",
            "country_code": "US",
            "telephone_number": "918-851-6395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONNERMAN",
        "first_name": "JAMIE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-18",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Glass, MHPP
• David Bruce Glover, M.D.
• Rhonda L Godsby, MHPP
• Adam Craig Gold, MD
• Amanda Marie Gold
• Christopher Gonzalez, CIT, RDS
• Hayley Gonzalez, COTA
• Isamar Gonzalez, QBHP
• Jazmin Gonzalez
• Manuel Gonzalez, FNP-BC

• Speech-Language Pathologist in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Speech-Language Pathologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.