Individual provider Active NPI

Pamela Jan Grozanick

  • Speech-Language Pathologist
  • Altoona, PA
National Provider Identifier
1104164334
Registry record updated Jan 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SL001421L Issued in PA
Practice address
4 Sheraton Dr
Altoona, PA 16601-9316
Phone
(814) 949-2050
Fax
(814) 949-2051
NPI assigned
Jan 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SL001421L PA Primary

Addresses

Primary practice location

4 Sheraton Dr
Altoona, PA 16601-9316

Mailing address

1174 Grozanick Rd
Patton, PA 16668-6501
Phone (814) 949-2050

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

State licenses

LicenseStateTypeSpecialty
SL001421LPAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Procare PT LP 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1104164334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1174 GROZANICK RD",
            "city": "PATTON",
            "state": "PA",
            "postal_code": "166686501",
            "telephone_number": "814-949-2050",
            "fax_number": "814-949-2051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SHERATON DR",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166019316",
            "telephone_number": "814-949-2050",
            "fax_number": "814-949-2051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROZANICK",
        "first_name": "PAMELA",
        "middle_name": "JAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-23",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL001421L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.

Verify at the official NPI Registry.