Connie Marie Gonzalez, MSCCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

10913 Issued in AZ

Practice address

127 Carter St
Richmond Hill, GA 31324-3753

Phone

(912) 756-6131

NPI assigned

Mar 12, 2013

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

Enrolled in AZ

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Empowerme Rehabilitation LLCGroup PAC ID 2769723162, 423 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Empowerme Rehabilitation, LLC

  • Multi-Specialty Clinic/Center
  • Scottsdale, AZ
  • NPI 1144954074

  Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD
• Empowerme Rehabilitation, LLC

  • Multi-Specialty Clinic/Center
  • Williamsburg, VA
  • NPI 1881366730

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1363046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1083955397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11053 E TRIPOLI AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852128562",
            "telephone_number": "321-228-6785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 CARTER ST",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313243753",
            "telephone_number": "912-756-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "CONNIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MSCCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-12",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP007167",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "10913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Gipson, RBT
• Storman Glass
• Richard W Glover, OTR/L
• Goal Mentality LLC
• Claudia Gonzalez Erigolla, PSY.D.
• Melissa Ann Gonzalez
• Matthew Good, PA-C
• Catherine Corish Grant, PA-C
• George Grant, O.D.
• Janice Tillman Gravitt, RN

• Speech-Language Pathologist in Richmond Hill, GA
• Providers in Richmond Hill, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.